5 Things to Know About Heartburn

By Ernst Lamothe Jr.

Gastroenterologist Borys Buniak
Gastroenterologist Borys Buniak

Heartburn affects one in five adults, and can make life miserable. It is a painful burning feeling in your chest or throat. It happens when stomach acid backs up into your esophagus, the tube that carries food from your mouth to your stomach. If you have heartburn more than twice a week, you may have gastroesophageal reflux disease — GERD. (See separate story in this issue).

“It’s not just what types of food we tend to eat, but also how much food we eat and when we eat it,” said Borys Buniak, gastroenterologist at the Heartburn Center at St. Joseph’s Health in Syracuse. “All of these behaviors have a negative impact on our digestive system, and often cause uncomfortable flare ups of heartburn.

Buniak has these five tips for reducing heartburn.

1. Eat smaller meals.

It’s difficult when you are hungry to worry about portion size. However it has a direct correlation with heartburn depending on the amount and type of foods you are eating. When we overeat, sometimes we regurgitate elements into our esophagus or mouth and that is often why we have a burning sensation in our chest.

“Some people describe chest pressure when this happens, which could be confused with symptoms of a heart attack,” said Buniak. “Regurgitation may also cause a chronic cough or hoarseness if the vocal cords or lungs become irritated by stomach contents. To avoid this situation after a large meal, eat smaller meals and avoid bending over.”

He also recommends not leaning or laying down after eating because the action tilts your stomach and allows acid to flow into your esophagus.

“The only way to control heartburn is to eat smarter foods, in smaller portions,” he added. “Try eating light appetizers like shrimp and vegetables to front-load your meal, and avoid over-eating the fattier foods during the main course and dessert.

2. Avoid bedtime snacks.

Eating late into the evening has adverse effects for many reasons. It can lead to weight gain because once you eat late there isn’t an opportunity to burn those calories away. There are times when it might slow down your metabolism. It is also one of the known risk factors for causing heartburn.

“Eat meals at least two to three hours before lying down to prevent reflux,” he said.  “Some people may wake up to a choking sensation if food backs up into the back of the throat. Certain foods you eat also may aggravate symptoms. Sleeping with the head of the bed elevated usually allows gravity to keep gastric contents from backing up into the esophagus. Wedge pillows are also helpful.”

3. Avoid trigger food.

Gastroesophageal reflux disease (GERD) is one of the most common disorders of the digestive tract, affecting about one in 45 U.S. adults, according to the National Institute of Health. GERD may cause discomfort while eating and over time can lead to serious medical conditions, such as esophagitis, Barrett’s esophagus and cancer But, like many ailments, it can often be prevented or controlled through diet and lifestyle changes. There are several foods that consistently trigger heartburn. Common trigger foods include spicy meals, fatty red meat, fried foods, citrus fruits, tomatoes, raw onion, tomato sauce, butter, oils, chocolate, alcohol and caffeine.

“Taking antacids, such as Gaviscon or H2 blockers, such as Pepcid or Zantac, before or after meals containing these trigger foods may alleviate most heartburn symptoms,” said Buniak.

Also taking other over-the-counter medication only treats the symptoms temporarily and does not treat the actual problem that causes heartburn.

4. Weight Loss.

When overweight, the fat surrounding your abdomen will press against the stomach, pushing acid or food upward into the esophagus. This can be aggravated by lying flat. Losing weight helps reduce heartburn. Sleeping on a wedge often helps reduce nocturnal reflux events. Sleeping on your left side may also reduce acid backup into the esophagus.

5. Quit smoking.

By now, we all know the information about smoking being bad for individuals and the overall population. And while the statistics are encouraging with the number of young smokers dropping with each year, issues persists because other elements have filled in the void of tobacco. But there are other random facts that many people don’t know about smoking, food and digestive issues. Smoking cuts down saliva production. Saliva helps flush stomach acid out of the esophagus and it contains bicarbonate which neutralizes acid.

“Nicotine also reduces the lower esophageal sphincter pressure allowing more gastric acid to back up into the esophagus,” said Buniak. “Chewing gum after meals increases saliva production and reduces esophageal acid levels. Chronic reflux and smoking also increases one’s risk for esophageal cancer.”

In addition, when you quit smoking, your taste buds come back to life.