How to ease heartburn without drugs

Friday, 23 November 2012

Heartburn is more than just a minor discomfort; it can significantly reduce quality of life. Expert warns that heartburn, this burning feel in the chest or throat, can be eased by many simple lifestyle modifications, including weight loss, reports Sade Oguntola.

Maybe it was that beans supper taken last night or overindulgence at a holiday meal, but at one time or another, most people would have dealt with the unpleasantness of heartburn. For most people, it is a rare occurrence.

Doctors call it gastroesophageal reflux disease, or GERD. Millions of people, because of its burning feel in the chest or throat, call it heartburn. By any name, GERD is common, bothersome, and sometimes serious. It can significantly reduce quality of life.

One survey revealed that 65 per cent of people with heartburn may have symptoms both during the day and at night, with 75 per cent of the night-time heartburn patients saying that the problem keeps them from sleeping, and 40 per cent reporting that night-time heartburn affects their job performance the following day.

A chest physician, Dr Cyril Chukwu, at the Lagos University Teaching Hospital (LUTH), described heartburn as an uncomfortable, but common feeling of burning or warmth in the chest.

Although, the pain of heartburn is felt in the chest, he stated that heartburn has nothing to do with the heart. Instead, heartburn is caused by stomach acid.

The frequency of stomach acid reflux (backflow of liquid) varies from one person to another. But, Dr Chukwu stated that “for many people, it happens very rarely while in others, it is a weekly or daily incident. Heartburn usually occurs after eating a large meal or drinking a lot of alcohol, chocolate, peppermint, coffee and smoking of tobacco that obstruct the function of the sphincter.”

The ring-like muscles of the lower oesophagus that prevent swallowed foods from returning from the stomach back into the oesophagus is called the lower oesophageal sphincter (LES). When the stomach is full, a tiny amount of food can sneak back into the oesophagus after it was swallowed. That is normal.

But in people with GERD, substantial amounts of stomach acid and digestive juices backwash into the oesophagus. Heartburn is a symptom of gastroesophageal reflux disease (GERD) in which acid and stomach enzymes rise from the stomach into the oesophagus. This is much like water bubbling into a sink from a plugged drain.

Heartburn and “acid indigestion” are the most common result. A burning pain is usually accompanied by burping or bloating points to GERD as the cause. Sometimes, signs of GERD are noticed in the lungs, mouth, and throat. This includes a sour or bitter taste in the mouth; the regurgitation of food or fluids, sore throat or the need to clear the throat and persistent coughing without apparent cause, especially after meals.

Anyone, including infants and children, can have GERD. Many women experience this sensation during pregnancy. If not treated, it can lead to more serious health problems. In some cases, medicines or surgery are required to treat it to prevent it causing damage to the oesophagus and even increasing the risk of cancer. It’s important to consider the possibility that chest pain may mean a heart attack instead of heartburn.

Some people with GERD need to turn to medications to relieve symptoms and prevent possible long-term damage to the oesophagus. Medicines called antacids can be helpful for some people who have GERD. These work by lowering the amount of acid in the stomach. They should only be used for a short time because they can cause side effects and might not control the problem for very long.

For long-term problems, doctors may prescribe other medicines. Some work to lower stomach acid. Other medicines can help make the sphincter muscle stronger and help the stomach empty more quickly. If nothing else works, a person may need surgery to treat GERD, but this isn’t done very often.

But simple lifestyle modifications can control heartburn and other GERD symptoms. These include the following:

Eat smaller meals: A large meal remains in the stomach for several hours, increasing the chances for gastroesophageal reflux. It puts pressure on the muscle that normally helps keep stomach contents from backing up into the oesophagus. Of course, the more food that is consumed, the longer it takes for the stomach to empty, which contributes to reflux.

Avoid late-night eating: It is important to eat three hours before going to bed, to leave enough time for the stomach to clear out. Having a meal or snack within three hours of lying down to sleep can worsen reflux, causing heartburn.

Don’t exercise right after meals. Wait at least two hours after a meal before engaging in vigorous physical activity in order to give the stomach time to empty. But don’t just lie down either, as this will worsen reflux.

Sleep on an incline: Elevate the head of your bed by placing a wedge under the upper body if affected by night-time heartburn. But don’t elevate your head with extra pillows. Doing so makes reflux worse by compressing your stomach.

Stop smoking: Nicotine stimulates stomach acid. It also impairs the body’s ability to keep stomach contents in place.

Identify and avoid foods associated with heartburn: Common foods that contribute to heartburn include fatty foods, spicy foods, garlic, milk, coffee, tea, cola, peppermint and chocolate. Carbonated beverages cause belching, which also causes reflux.

Lose weight: Being overweight puts more pressure on the stomach and pushes stomach contents into the oesophagus. Tight fitting clothing and belts that come with weight gain may also worsen heartburn.

Relax well before and after meals: Stress increases the production of stomach acid, so make meals a pleasant, relaxing experience. This may help prevent and relieve heartburn.

Rule out medication side effects: Drugs that can predispose to reflux include aspirin and other NSAIDs, birth control pills, hormone therapy, narcotics, certain antidepressants and some asthma medications.

Chew sugarless gum after a meal: Chewing gum promotes salivation, which helps neutralise acid, soothes the oesophagus and washes acid back down to the stomach. But avoid peppermint gum, which may trigger heartburn more than other flavours.