Alleviate Heartburn with a Few Simple Lifestyle Changes

By Christine Strohmeyer, MD, Scripps Health

Most of us have experienced heartburn at one time or another – that uncomfortable burning discomfort in your chest or throat, and can also be accompanied by a bitter taste in the throat. This extremely common condition is often worse when lying down or bending over and can last for a few minutes or a few hours.

According to the American College of Gastroenterology, about 60 million Americans experience heartburn at least once a month and about 15 million have daily flare-ups. Pregnant women are particularly susceptible, with more than half reporting symptoms during their second and third trimesters.

The unpleasant sensation is caused an irritation of the esophagus caused by stomach acid that flows back into your food pipe. A muscular valve called the lower esophageal sphincter, located where the esophagus meets your stomach, acts like a gate allowing food to pass into the stomach. Usually, this valve closes as soon as food passes through. But, if the valve opens too often or does not close tightly enough, stomach acid can leak into the esophagus and cause heartburn.

While occasional heartburn is no cause for alarm, it can be irritating, and a few simple lifestyle changes can help prevent the condition from ruining your evening.

• Avoid triggers that can bring on heartburn. Triggers can vary, but common culprits include fatty, fried and processed foods, acidic foods (such as tomato sauce and spicy salsa) carbonated soda and caffeine. Coffee packs a double punch because it is acidic and has caffeine, and blended coffee drinks are a triple whammy of fat, sugar and caffeine. Patients who give up or cut back on coffee and switch to teas often find immediate relief.
• Don’t eat before bed. To increase your chances of a sweet slumber, Dr. Strohmeyer recommends waiting at least four hours after eating before your head hits the pillow.
• Similarly, don’t lie down after eating. Staying upright uses the force of gravity to keep food down, so don’t stretch out on the couch after that big celebratory meal. Take a leisurely walk instead, and your stomach will thank you. Eat slowly. Think Zen when you sit down to a meal, and savor your food. An added bonus is that you will probably consume fewer calories.
  
• Eat frequent small meals or snacks.
  
• Lose weight. Extra weight puts pressure on the stomach and makes it more likely that food can be forced back into the esophagus.
  
• Chew gum. A study in the medical journal Digestion found that chewing gum helped to speed up the rate at which acid was cleared from the esophagus, relieving heartburn pain.
  
• Drink water and other liquids at room temperature to aid digestion.
  
• Over-the-counter (OTC) medications can provide relief. Antacids, such as Mylanta and Tums, offer quick relief for some people. H-2-receptor blockers, such as Tagamet and Zantac, are stronger and can provide longer relief. Omeprazole, known by the brand name Prilosec, is the strongest OTC medication for heartburn. It works by severely decreasing the amount of acid in the stomach. However, prolonged use, more than 14 days, can also decrease the absorption of important nutrients, such as calcium.

It is important to maintain some acid the stomach. If there isn’t enough acid, the normal chemical reactions required to absorb nutrients are impaired. Over time, this can lead to conditions such as osteoporosis.  

Pregnancy and heartburn

Pregnant women often experience heartburn because of changing hormone levels, which can affect the muscles of the digestive tract and how different foods are tolerated. The condition usually disappears following childbirth.

Simple steps to reducing heartburn during pregnancy without hurting your baby include:

• Sleeping on your left side.
  
• Keeping your head at least six inches higher than the foot of your bed.
• Holding your head above your stomach helps prevent stomach acids from rising into your chest.

Seek medical care

Go to the nearest emergency room if you experience severe chest pain, especially when combined with other symptoms, such as difficulty breathing or pain in the arm or jaw.

See your primary care doctor if:

• Heartburn occurs more than twice a week.
• You have difficulty swallowing.
• Heartburn is interfering with daily living.

If you have heartburn on a regular and frequent basis, you may have gastroesophageal reflux disease, or GERD, which can damage the esophagus and cause serious complications. Some people with GERD may need prescription medications to reduce symptoms. If those drugs don’t provide the relief and symptoms persist, other treatment options exist. For example, Scripps Health offers incisionless surgery for GERD that can correct the faulty valve and prevent the reoccurrence of symptoms. Be sure to consult with your physician about what the right course of treatment is for you.

Christine Strohmeyer, MD, a family medicine physician at Scripps Coastal Medical Center. For more information on staying healthy or for a physician referral, please call 1-800-SCRIPPS.