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What is heartburn?
Whether an occasional experience or a regular occurrence, understanding what causes heartburn can be the key to overcoming this uncomfortable digestive concern. The word heartburn is a common term that, in fact, has nothing to do with the heart. The result of stomach acid backing up into the esophagus, heartburn denotes the characteristic pain and burning felt in the chest area. It can be brought on by pregnancy, obesity, certain foods, alcohol, and some medications.
What is acid reflux?
Also called gastroesophageal reflux, acid reflux involves stomach acid flowing back into the esophagus. Heartburn is one of the most common symptoms of acid reflux. While heartburn is a symptom of acid reflux, some individuals may not experience a burning sensation at all. Instead they may report a dry cough, asthma symptoms, or having trouble swallowing.
What causes acid reflux?
Normally, when food or liquid enters the stomach, a band of muscle called the lower esophageal sphincter, located at the end of the esophagus, closes. If this band does not close tightly enough, contents from the stomach can back up (reflux) into the esophagus. Partly digested material as well as acid can irritate the esophagus, causing heartburn and other symptoms.
During pregnancy, acid reflux can be very common. As the fetus grows, increasing pressure in the abdomen can cause stomach contents to back up into the esophagus, giving rise to heartburn, indigestion, and overall discomfort.
A hiatal hernia, which is the protrusion of the stomach upward through the diaphragm, can also be an underlying cause of acid reflux. Often painful, hiatal hernia can present with a wide range of digestive concerns such as heartburn, as well as nonspecific symptoms such as shortness of breath and dull chest pain.
Dietary and lifestyle choices to prevent heartburn
When most of us think of heartburn, we may picture a night of indulgence. However, occasional and frequent heartburn can be caused by a number of dietary and lifestyle factors which, when modified, can prevent a painful episode.
Foods to avoid
While trigger foods can vary with the individual, certain foods are known to exacerbate acid reflux. Tomatoes, tomato sauces, peppermint, spearmint, and even chocolate have been shown to cause heartburn.
A study conducted in Singapore looked at the consumption of curry, a combination of spices used commonly in Eastern cooking. Researchers found that consuming curry exacerbated gastroesophageal reflux disease (GERD), where heartburn occurs more than twice a week, and therefore should be avoided by those diagnosed with GERD.
Foods to eat
Known as a bland diet, certain foods are recommended for those prone to suffering from chronic heartburn. Characterized by mostly low-fat foods, a bland diet consists of foods that can effectively soothe the burn of acid reflux. Foods that are suggested include low-fat dairy products, lean meats, eggs, oatmeal, cream of wheat, tofu, broth, and tea.
When to eat
Overall, eating smaller meals throughout the day can decrease the likelihood of acid spewing out of the stomach into the esophagus, causing the characteristic burning sensation.
What to drink
Often overlooked, what you drink can have a serious impact on heartburn. An interesting clinical article published in Seoul, Korea, showed a direct link between acidic beverages and heartburn. While coffee was linked to a high incidence of heartburn, oolong tea, a type of green tea, was shown to have less likelihood of precipitating an attack.
Regular milk was shown to cause more heartburn than low-fat milk, while carrot juice was shown to be less irritating than citrus juices.
Sleep position can play a role in heartburn relief. Sleeping with the head raised six inches higher than the stomach can prevent digested food from backing up in the esophagus. An interesting aspect of reflux disease is known as nighttime heartburn or nocturnal gastroesophageal disease.
In some individuals, heartburn experienced during sleep can be the cause of disrupted sleep as well as frequent waking. Eating the last meal of the day well before sleep time can greatly reduce this lesser known aspect of the disease.
Tight-fitting belts or clothes that fit snugly around the waist, squeezing the stomach, may force food to reflux. Wearing loose clothing, especially when the threat of reflux is greater, such as during pregnancy, can greatly prevent attacks.
Exercising and weight loss
Avoid the act of bending or exercising just after eating to help prevent acid reflux. As well, an overall reduction in body weight can reduce the pressure on stomach contents. Studies have shown that a reduction in stress can also help prevent acid reflux.
Since chemicals in cigarette smoke can irritate the lower esophageal sphincter, smoking cessation can greatly improve incidences of heartburn.
An interesting study looked at the effect of chewing sugar-free gum on acid reflux. Chewing sugar-free gum for half an hour after a meal was shown to significantly reduce acidic esophageal reflux following the meal.
Gastroesophageal reflux disease
While occasional heartburn is not a grave concern, in situations where acid reflux occurs frequently, the obvious concern is damage to the lining of the esophagus. Heartburn that occurs more than twice a week is defined as gastroesophageal reflux disease and requires closer investigation and treatment.
Different aspects of lifestyle and diet come together in the prevention of heartburn. From wearing loose clothing to avoiding fatty foods to chewing gum, heartburn can be successfully addressed using a wide range of tactics. Hence, following healthy digestive tips and a bland diet may help you escape the wrath of heartburn and also improve overall optimal digestion and health.
Heartburn or heart attack?
Learn how to tell the difference between heartburn and a heart attack.
Common heart attack symptoms
- squeezing and pressure in the chest
- pain spreading to the shoulders, neck, or arms
- light-headedness, weakness, or dizziness—even cold sweats
- shortness of breath, along with nausea and possible vomiting
- When in doubt, always consult a health care practitioner or seek emergency medical services.
Common heartburn symptoms
These characteristics of heartburn will help you distinguish between the two.
- Pain generally does not radiate to the shoulders, neck, or arms (although it may).
- Pain usually comes after meals.
- Symptoms usually respond quickly to antacids.
Natural heartburn remedies
These remedies can help reduce the pain of heartburn:
- barberry: in tea form, or 30 to 60 drops as a tincture up to three times per day
- Roman camomile: as a tea three to four times per day
- melatonin: 3 mg at bedtime
- bifidobacteria: 17 billion colony forming units (CFU) daily
Quick tips for healthy digestion
- Avoid high-fat meals and fried foods.
- Skip coffee—it’s a known digestive irritant.
- Avoid excessive irritants such as alcohol, caffeine, citrus juices, and carbonated beverages.
- Don’t eat for three to four hours before bedtime.
- Stop smoking.
About the Author
Priyanka Gupta, ND, is a licensed naturopathic physician. She focuses on family health and is passionate about prevention through patient education.