Finding heartburn relief
Wednesday, October 3, 2018
Q: I have been taking a medicine to treat heartburn. I have heard that might not be a great idea anymore and that there can be some long-term consequences for taking them. What can I do to naturally reduce or treat my heartburn? — L.J.C., Winterville
A: I asked Kathryn Clary, a second-year Brody Medical student, to tell you about some lifestyle behaviors that can make your heartburn better or worse. Here is what she wants you to know.
Heartburn is a common problem for many of us. We couldn’t find any statistics for North Carolina, but about 2 in 10 adults in the U.S. experience it. It is a painful, burning feeling in the throat or chest.
It’s good to have some background on digestion, to better understand why heartburn happens in the first place. Heartburn is the most common symptom of acid reflux, which is when stomach acid gets pushed into the esophagus. The esophagus is where food and drink go once swallowed — it is the tube that connects your mouth to your stomach. Food is supposed to move in one direction: from the mouth to the esophagus and then to the stomach.
In order to keep stomach contents from moving backward, we have a ring-shaped muscle in between the end of the esophagus and the stomach that stays tightly clenched, keeping stomach contents where they belong. Sometimes, this muscle doesn’t close all the way, and stomach acid goes into your esophagus, causing heartburn. Other common symptoms of reflux include difficulty swallowing, an acidic taste at the back of the mouth, and cough.
Here are 5 simple lifestyle changes that may help to reduce your acid reflux and heartburn.
1. Eat smaller portions. Remember that ring-shaped muscle between the esophagus and the stomach? This muscle is known as the lower esophageal sphincter (we’ll call it the LES). In some people with acid reflux, the LES is weakened or doesn’t work like it should. But even in people with a strong LES, if there is too much pressure on the muscle, acid can squeeze through and make its way back into the esophagus. The more food there is in your stomach, the more it stretches, putting more pressure on your LES. For this reason, larger meals may worsen reflux symptoms, so instead, try eating smaller portions more often to minimize heartburn.
2. Cut out carbonated drinks. A few studies have shown that drinking carbonated sodas is linked to increased reflux symptom potentially weakening the LES for a short period of time. The bubbles in carbonated drinks are of carbon dioxide which leads to belching. When you belch, your LES opens to let the air pass, which allows stomach acid to go into the esophagus. Try plain or non-carbonated flavored water. You may hear that other foods worsen acid reflux include fatty foods, caffeine, chocolate, spicy foods, and peppermint, but the evidence is mixed. But if they bother you, limit your intake.
3. Slim down your belly. Extra pounds are the reason behind many chronic health problems and may be true for heartburn. The diaphragm is a muscle that lies above your stomach and helps to keep the LES closed. Extra pounds around your midsection can push the LES upward and away from the support of the diaphragm. This is called hiatus hernia. Many studies have shown that extra pounds increase the risk of reflux and show that weight loss can help relieve heartburn.
4. Give your head a lift. If you have reflux at night, raising the head of your bed about 6 inches may help. Place bricks, bed risers, or even old books under the feet of your headboard. This places your esophagus slightly above your stomach, which lessens the backward pressure of stomach contents on the LES. Or use a wedge foam pillow which lifts your head, shoulders, and torso. Studies have shown that people who raised the head of their bed had less heartburn episodes and fewer symptoms.
5. Eat dinner earlier. When you eat a meal, your stomach begins to churn out acid to help with the digestion process. People with reflux might do better if they avoid eating within 3-4 hours of bedtime. Not all studies show an effect. If you feel like your heartburn is worse when you eat dinner later, try eating earlier and see if your reflux improves.
To put it simply, some people find relief from heartburn by making diet and lifestyle changes, while others require medication or other treatment. There are three medicines available without prescription: Tagamet, Pepcid and Prilosec. Even though they are sold over the counter there can be side effects. Especially if taken for a long time. Pay close attention to the directions on the box. It is always best to talk to your doctor about all your medications, your diet, and your lifestyle to see how to manage your heartburn.
Professor emeritus Kathy Kolasa, a registered dietitian nutritionist and Ph.D., is an Affiliate Professor in the Brody School of Medicine at ECU. Contact her at firstname.lastname@example.org.