© CHAJAMP / SHUTTERSTOCK
BY SUZANNE BADIOZZAMAN
EVERY MONTH, ;; percent of Americans
suffer heartburn, according to health
agencies. If left unchecked, chronic heartburn—painful heartburn occurring more
than twice a week—can become more than
an annoyance; it can be a gateway to gas-troesophageal re;ux disease (GERD) and
other life-threatening illnesses.
What is heartburn?
When we eat food, acid plays an important role in digestion, but for many people
the amount of acid produced may be excessive, so much so that it forces its way up
from the stomach, past the lower esophageal sphincter to the lower esophagus,
which lacks the thick mucus to protect it.
We feel this esophageal pain behind the
sternum, near the heart, hence the misnomer “heartburn.”
A big meal can build too much volume
and pressure, resulting in digested food
particles and acid forcing their way up. It’s
better to have smaller meals spread
throughout the day.
The composition of what you’re eating
could also be what’s o;ending your stom-
ach, from the gas in carbonated drinks to
spicy foods, from canned foods heavy in
preservatives to too many acidic foods, such
as caffeine, chocolate, alcohol, tomato-
based foods, citrus fruits, raw garlic and
onions—even excess sugar and salt. Also,
large, high-fat meals tend to stay in the
stomach longer, increasing pressure, and
therefore are more likely to push acid up.
Besides food, certain actions are to
blame for heartburn.
Gravity is one possible culprit: Simply
lying down soon after eating, before the
stomach completely empties, can cause
food to come up instead of go down and
stay down. Try to wait at least three hours
before fully reclining to help prevent
heartburn symptoms. It also helps to eat
lighter meals in the evening and limit having food near bedtime.
Elevating the head while you sleep may
help as well. Place a ;- to ;-inch wedge at the
head of the bed between the mattress and
the box spring. Use a wedge pillow or consider getting an adjustable mattress that
allows you to raise the head.
Avoid tight clothes, such as belts, pants
or waist-training garments, which can
increase pressure on the stomach, squeezing enough to cause an increase in re;ux.
Other causes of heartburn include
being overweight, being pregnant, drinking alcohol and smoking.
Addressing the problem
Changing your diet is your best line
of defense. Identify and remove acid-producing foods from your diet. Registered
dietitian and Costco member Marissa
Kent recommends keeping a food diary.
She suggests writing down what you’ve
eaten and what, if any, problems resulted.
“I encourage clients to keep track of what
causes them problems,” she says. Once the
trigger foods are identi;ed, “I usually rec-
ommend they be avoided.”
One strategy is to eat more alkaline-
promoting (non-acid-promoting) foods,
such as grilled and baked meat, vegetables,
breads, rice, oatmeal, alkaline water, soy
and coconut milk, melons, pears, bananas,
ginger, chamomile tea and manuka honey,
to balance your diet.
Antacids and acid reducers
Occasional heartburn sufferers can
;nd relief with antacids, which temporarily pacify symptoms by neutralizing acid.
If they are taken on a full stomach, relief
can last for hours.
Frequent heartburn sufferers prefer
acid reducers, such as proton-pump inhibitors (PPIs). These reduce acid production
at the source. Although prescription and
over-the-counter PPIs are safe, less acid
production means food digestion can
become more di;cult and the body may be
less able to defend against bacteria that can
cause serious infections or pneumonia.
Other possible side effects include
dependence, diarrhea, gastrointestinal
discomfort and a reduction in stomach
enzymes that destroy alcohol, which may
produce a higher-than-expected blood
alcohol concentration per drink. Be sure to
discuss pros and cons with your doctor.
Long-term use comes with a caveat.
“The antacids and PPI medications are
concerning when they are prescribed
without people making dietary changes,
like drinking less coffee, alcohol, etc.,”
says Kent. “Those meds deplete the body
of vitamin B;; and magnesium. In addi-
tion, sometimes people who have heart-
burn or indigestion su;er from low acid
Kent hopes that increasing awareness
of the long-term e;ects of PPI medications
can provide motivation for heartburn
patients to make dietary changes.
Addressing the problem
Always talk to your doctor about heartburn symptoms occurring daily, several
times a day and especially at night, because
it could be an indication of a more serious
condition. Self-medicating can mask
symptoms of an ulcer, hernia and/or
GERD, all of which could lead to cancer
or other serious health consequences if
left unchecked. C
Suzanne Badiozzaman is a freelance writer
and nutritional consultant.
the heat of heartburn
FOR YOUR HEALTH
Costco members can find a variety of over-the-counter and prescription medicines for
heartburn at Costco and on Costco.com.