Eating tips when heartburn hits (acid reflux)

Dear Reader,

Gastroesophageal reflux disease (commonly referred to as GERD) occurs when the contents of the stomach back up into the esophagus. Since the esophagus doesn't have the same protective lining as the stomach, these acidic substances cause irritation and discomfort. Although this has nothing to do with the heart, it is frequently called heartburn because a burning sensation is felt just behind the breastbone.

The reflux, or burning, is a symptom of a malfunction of the digestive tract — specifically, the muscle connecting the esophagus to the stomach isn't working properly. In normal digestion, this muscle, called the lower esophageal sphincter, opens to allow food into the stomach, then closes. In GERD, this muscle is weak and relaxes, allowing backflow of the stomach's contents since it is not shutting properly.

In the digestive process, the stomach secretes strong acids that are needed for enzymes to do their job. Some people produce more acid than is needed, which contributes to the problems of GERD. It is often believed that spicy or citric foods cause GERD, which is not exactly true. More accurately, they often cause the acidic contents of the stomach to be more irritating to the esophagus. In any event, people who have GERD are usually recommended to stay away from these irritating foods:

• Citrus juices
• Tomato products
• Coffee
• Spicy foods
• Carbonated beverages
• Any other food that regularly causes heartburn for them (this varies from person to person)

Other strategies for people with GERD center on increasing the pressure of the lower esophageal sphincter to prevent backflow of the stomach's contents, including:

• Increasing consumption of lean proteins (these help the sphincter to close)
• Decreasing dietary fat intake (fat remains in the stomach for a long time, keeping the sphincter open longer)
• Not smoking
• Avoiding peppermint and spearmint
• Staying away from both regular and decaffeinated coffee, strong tea, and chocolate

Keep the contents of the stomach small to help close the sphincter. People can eat small, frequent meals, and drink fluids between meals, rather than with meals. It's also a good idea to avoid lying down for two to three hours after eating. When people do lie down, some find relief in elevating the head of their bed by six inches, or by sleeping on a specially designed wedge to help clear the stomach's contents from the esophagus.

Excessive use of antacids is not a good idea because they can interfere with the absorption of some vitamins and minerals. Chronic acidic irritation to the esophagus can cause permanent swallowing difficulties, so consider seeking treatment to avoid any permanent complications. In rare cases, esophageal cancer can result. If none of these strategies help, prescription medications may be needed to help reduce acid production, hasten stomach emptying, or increase the strength of the lower esophageal sphincter. Your health care provider will be a valuable resource.