Heartburn. The word evokes a frightening picture: Your heart on fire, sizzling and smoking, without a fire fighter in sight. Fortunately, the word is a misnomer. It's not your heart that's on fire, it's your esophagus. But heartburn is easier to say than esophagus burn.
The burn part, however, they got right. Your esophagus, the food tube that carries what you swallow down to your stomach, can literally be burned by the acids released by your stomach. Those acids are industrial strength stuff and are meant to stay where the tough stomach lining can handle them.
Unfortunately, we can experience something called reflux. That's when some of the stomach contents, including the acid, slip back up through the esophageal sphincter, the valve that's supposed to prevent the stomach's contents from reversing course.
David M. Taylor, M.D., a gastroenterologist and assistant professor of medicine at Emory University in Atlanta and at the Medical College of Georgia in Augusta, puts it plainly: If it goes south, that's good; if it goes north, you're in trouble.
Reflux causes an uncomfortable burning sensation between the stomach and the neck. Most people feel the discomfort right below the breastbone.
The easy way to avoid a simple case of heartburn? Moderation. Heartburn is generally the result of eating too much too fast. But if it's too late for moderation, here are some ways to put out that fire and keep it from flaring up again.
Take an antacid.
Over-the-counter antacids in tablet or liquid form can help cool the burn. Take a dose about every six hours as needed, says Nalin M. Patel, M.D., a gastroenterologist in private practice and clinical instructor at the University of Illinois at Urbana-Champaign. Don't overdo it, though, because too much antacid can cause constipation or diarrhea.
Don't forget your bedtime dose.
Even if you forget to take an antacid during the day, try to remember to take one at bed-time to protect yourself from the pooling of stomach acids. Nighttime damage is probably the worst that will occur, because you're bathing your esophagus in acid, and you're much more prone to burn it, says Douglas C. Walta, M.D., a gastroenterologist in private practice in Portland, Oregon. Try keeping a bottle of antacid on your night stand so that you remember to take your nightly dose.
Is It Really Heartburn?
If symptoms don't subside, you may have something other than a simple case of heartburn.
Persistent heartburn can be a sign of significant disease, warns David M. Taylor. M.D. They [persistent heartburn sufferers] can have hiatus hernia or esophagitis [inflammation of the esophagus], they can have an ulcer in their stomach, they can have an ulcer in the duodenum [part of the small intestine], and in an older person, they can even have cancer. And sometimes heartburn can mimic coronary disease, and they can have heart trouble.
The best advice: If symptoms persist, see your doctor.
Keep your head up.
Another way to protect your esophagus while you sleep is to elevate the head of your bed. That way, you'll be sleeping on a slope, and gravity will work for you in keeping your stomach contents where they belong. Put wooden blocks or bricks under the legs at the head of your bed in order to bring it up about six inches, advises Patel.
Have a glass of milk.
Milk can sometimes cut the acid and decrease heartburn, says Taylor.
Get rid of your waterbed.
People with waterbeds who have reflux have to get rid of their waterbeds, says Walta. They don't like to hear that. The problem with a waterbed is that your body basically lies flat on the water-filled mattress. You can't effectively elevate your chest and so can't keep your stomach contents from heading north.
Say no to the couch.
Tempting as it may look, the couch is not your friend after eating a meal. People who lie down with a full stomach are asking for trouble. Stay upright for one hour after meals, says Patel.
Don't eat before bed.
Heading from the dinner table to bed is a no-no for heartburn sufferers. In fact, doctors recommend warding off sleepy time for two to three hours after a meal. And by that, they mean staying upright for that amount of time. You should stay upright until the gastric contents are emptied, says Walta.
Pass on seconds.
If you overeat, it's kind of like a balloon, says Walta. If you blow it up real tense, its more likely to empty quickly if you release the valve. A stomach, ballooned by too much food and drink, may partly empty in the wrong direction.
Loosen your belt.
Avoid tight clothing around the waist, says Patel. This tends to increase acid backing up into the esophagus.
Lose the fat.
If you're fat on the outside, you can be sure you're fat on the inside, too, says Walta. The fat competes for space with your stomach. Fat pressing against the stomach can cause the contents to reflux.
Don't blame the baby.
For the same reason that fat can impede normal digestion competition for space pregnancy can cause heartburn. That's all the more reason expectant mothers should watch what they eat and give up that nonsense about eating for two. Remember, pregnant or not, you only have one stomach. Be sure to discuss with your doctor any questions you may have about proper diet and weight gain during pregnancy.Get in shape.
Couch potatoes have heartburn, states Taylor. You almost never have heartburn when you exercise. Even mild exercise done on a regular basis, such as a daily walk around the neighborhood, may help ease digestive woes. However, avoid working out strenuously immediately after a meal; wait a couple of hours.
Watch your diet.
A high carbohydrate, low fat, high-bulk diet is the best thing, says Taylor. Fried foods and fatty foods should be avoided, he says, because they take longer to digest. Highly spiced foods sometimes contribute to heartburn as well.
Don't smoke.
Nicotine from cigarette smoke irritates the valve between the stomach and the esophagus, as well as the stomach lining, so smokers tend to get more heartburn.
Be careful of coffee.
It may not be the caffeine that's the problem. The oils contained in both regular and decaffeinated coffee may play a role in heartburn. Try cutting your coffee intake to see if your heartburn troubles subside.
Be wary of peppermint.
For some people, peppermint seems to cause heartburn. Try skipping the after dinner mints and see if it helps.
Take it easy.
A big contributor to heartburn is stress, says Taylor. Stress can create increased acid secretion and can cause the esophageal sphincter to malfunction.
Don't crack open a cold one.
Alcohol can relax the sphincter, notes Taylor. It can irritate the stomach, too, which can lead to reflux.
Slow down on soda.
Carbonated beverages and soda pop can contribute to heartburn woes. Carbonation causes stomach distention due to gas, and that causes acid rolling back up into the esophagus, Patel explains.
Check your painkiller.
If you're about to pop a couple of aspirin in your mouth, think again. Aspirin, ibuprofen, and products that contain them can burn the esophagus as well as the stomach, warns Walta. Opt for acetaminophen instead?
Hold the pepper.
For people with heartburn problems, using pepper is not such a hot idea, says Kimra Warren, R.D., a registered dietitian at St. Vincent Hospital and Medical Center in Portland, Oregon. Sprinkling or grinding pepper, whether red or black, onto your food may be contributing to your heartburn troubles, so try going easy on it.
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