Heartburn Remedies and Relief

Despite its name, heartburn does not involve the heart but rather the esophagus. Your esophagus is your body’s food chute, a tunnel of muscle whose job it is to push what you swallow into your stomach. And although this is supposed to be a one-way street, stomach acid sometimes rises back up, causing the fire we call heartburn.

Symptoms of heartburn can include a burning or painful sensation in the upper chest behind the breastbone, a sour taste in the mouth, belching, coughing and wheezing, difficulty sleeping after eating, regurgitation, and chronic hoarseness or sore throat.

Occasional heartburn can be caused by simply eating chocolate (it relaxes the gatekeeping muscle known as the esophageal sphincter) or lying down after a meal (the angle allows acid to escape). But a chronic burn can signal acid reflux or gastroesohageal reflux disease (GERD), a condition that occurs when the sphincter stops working properly. Left untreated, GERD can lead to a worse esophagus ailment: cancer.

If you frequently suffer from heartburn, you are not alone. In the United States, 44% of the adult population has reported experiencing heartburn at least once a month, 14% have reported experiencing it weekly, and 7% have reported experiencing it daily. Twenty-five percent of women have heartburn during their pregnancy. People are usually given a diagnosis of GERD when they have symptoms of heartburn and acid regurgitation at least once a week.

Nocturnal gastroesophageal reflux, which may result in heartburn during sleep, has been demonstrated to be associated with a more severe form of GERD. Unlike upright reflux (experienced while awake), which tends to be short and resolves quickly, supine reflux (experienced during sleep) tends to be longer and resolves slowly.

Recommendations for Wellness

• Eat small, frequent meals to avoid overeating. A distended stomach increases pressure on the esophageal sphincter, making heartburn more likely.

• Never lie down after eating because when you lie down after eating, food and acid are more easily pushed back into the esophagus. Wait at least three hours after meals before reclining, to allow acid production to subside and the stomach to empty.

• Avoid (or at least lessen the intake of) food and substances that decrease muscle tone in general and slow down the action of the esophageal muscular ring. Such foods and substances include fat, chocolate, cola drinks, coffee, and tobacco. Citrus fruits and tomatoes may also increase the risk of heartburn, especially when consumed before bedtime.

• We know that an allergy to cow's milk can cause acid reflux in babies. This is neither uncommon nor is it limited to infants. Adults often lack enough of the enzyme needed to digest lactose (milk sugar) or may have a sensitivity to milk protein. Either can cause heartburn. Some people drink milk to neutralize acid in their stomachs. This is only a temporary fix. Milk actually raises acid levels after it reduces stomach acid.

• Some people think that tea and alcohol contribute to acid reflux. Not according to two large studies in Norway with over 47,000 participants. Neither tea nor alcohol, in any quantity, affected them. Instead, researchers found that smoking daily for 20 years, or adding salt to foods for 20 years, were each linked to a 70% increased risk for heartburn.

• If you smoke, stop! Smoking decreases the strength of the esophageal valve, thereby allowing stomach juice to reflux, or flow backward into the esophagus. Smoking also seems to promote the movement of bile salts from the intestine to the stomach, which makes the stomach juice more harmful. Finally, smoking may directly injure the esophagus, making it less able to resist further damage from refluxed material.

• Helpful foods include pineapple, brown rice, potatoes, beans, whole wheat pasta, yogurt, salmon, tuna, sunflower seeds, asparagus, mushrooms and Brazil nuts.

• Avoid aspirin, ibuprofen, tetracycline, quinidine (a drug that reduces heart arrhythmias), potassium chloride, and iron.

• Be cautious about over-the-counter antacids. If you use antacids regularly, over a period of time, they can contribute to a host of more serious problems including arthritis, asthma, depression, digestive problems, and osteoporosis. Antacids don't correct heartburn. They just treat its symptoms.

• Be wary of any new drug because it takes many years for the full story to emerge. Propulsid is an outstanding case in point. This marginally effective but widely prescribed heartburn drug was removed from the market because it caused heart arrhythmia when combined with other common drugs, such as antibiotics. Propulsid was on the market several years before this potentially fatal adverse interaction was detected.

• If you are overweight — and even if you're not — embark on a diet and exercise program. Increased energy level and loss of weight will serve to take pressure off the esophageal muscular ring, helping to increase its productivity. Norwegian researchers found that people who swam or jogged for 30 minutes once a week were 50% less likely to suffer from the condition than the couch potatoes were.

• Do not wear tight clothes or tight belts.

• Sleep on your left side. Researchers at Graduate Hospital in Philadelphia monitored overnight ten middle-aged men and women with GERD, recording sleep positions and the number and duration of reflux episodes. All ten ate a greasy, high-fat dinner and a bedtime snack that night, a sure prescription for heartburn. The volunteers experienced reflux more often when sleeping on their backs and right sides than on their left sides. Moreover, acid took longer to clear from the esophagus when they slept on their right sides compared to other positions.

• Elevate the head of the bed or sleep with extra pillows.

• Make diet and lifestyle changes first. Then, if you don't get enough relief from these changes, talk to your doctor.