This piece was written by one of our contributors; medical student with a BSc in human nutrition and a MSc in clinical and public health nutrition – Rebecca Fox.
What is it?
Many of us have experienced the unpleasantness of heartburn, or at least know someone who has. This condition, somewhat confusingly, actually has nothing to do with your heart though! Rather, that burning feeling in your chest and throat is caused by stomach acid that moves out of the stomach (where it should be), and up into your esophagus (where it shouldn’t). The hydrochloric acid produced in your stomach is very strong- allowing it to help break down food and get rid of pathogens. Your stomach can handle the acid because it has a special protective lining. However, your esophagus doesn’t have that same lining, and is vulnerable to the nasty effects of stomach acid- causing that painful feeling in your chest. Clinically, this condition is referred to as gastro-esophageal reflux disease (GORD), or reflux for short. Other symptoms of GORD often include an unpleasant or sour taste, chest pain or abdominal pain, belching, and sometimes difficulty swallowing.
A number of factors cause some people to experience GORD more frequently than others including: older age, male sex, abdominal obesity, and tobacco use (1).
Note: These symptoms can also be the result of other medical problems so please speak to your GP if you are experiencing them
What makes it worse?
It turns out that there are a few things that seem to make heartburn worse for lots of people. These include (2):
Certain Foods and Beverages
Specific foods and beverages may be a trigger for some people, including:
- Mint 🌿
- Spicy foods 🌶
- Coffee and tea ☕️
- Chocolate 🍫
- Fatty foods 🧀
- Carbonated drinks 🥤
However, that’s not to say that everyone who gets heartburn will be triggered by all of these foods, but if you eat some of these things all the time, maybe try eliminating them for a little while and slowly reintroducing them one by one.
Late Night Eating
When you are sitting or standing, gravity works in your favour to help prevent acid from pushing its way up out of your stomach. However, you don’t get the lovely benefits of gravity when you’re lying down. So, try to schedule meals and snacks for earlier in the evening to let things digest before taking any after dinner naps.
Eating too fast
When you eat too quickly, your stomach may become overly full and cause stomach acid to be pushed out of your stomach. On the other hand, taking your time when eating gives your stomach a chance to start breaking food down and moving it into your intestines before more comes down the hatch. So, use this as another reason to practice mindful eating!
Smoking
Ok, we all know that smoking is bad, but smoking can (in addition to other things) make heartburn worse too! Nicotine, found in cigarettes, can cause the valve between the stomach and esophagus (lower esophageal sphincter) to relax, making it easier for acid to move out of the stomach
Obesity
Sometimes excessive weight can put more pressure on the abdominal region, causing stomach acid to be pushed upwards and outwards
Pregnancy
Pregnant women may experience increased GOR as extra pressure is placed on internal organs-including the stomach.
What makes it better?
Lifestyle
For many people, getting heartburn occasionally is no major cause for concern, and can be treated with some simple lifestyle changes including the ones listed above, as well as sleeping with your head elevated at night (3).
Medications
However, certain over-the-counter or prescription medications may also be taken to help with symptoms. These include:
Acid reducing medications (Proton Pump Inhibitors, H2 blockers, antacids)
- These medications reduce the amount of acid produced in your stomach
Alginate drugs (Gaviscon)
- These drugs create a foamy gel that sits on top of the stomach acid- preventing the acid from getting up into your esophagus.
As with any medication or lifestyle change though, talk to your GP first to help you with the best treatment.
References
(1) Richter JE, Rubenstein JH. Presentation and Epidemiology of Gastroesophageal Reflux Disease. Gastroenterology. 2018;154(2):267-76.
(2) https://www.health.harvard.edu/digestive-health/9-ways-to-relieve-acid-reflux-without-medication
(3) Ness-Jensen E, Hveem K, El-Serag H, Lagergren J. Lifestyle Intervention in Gastroesophageal Reflux Disease. Clinical Gastroenterology and Hepatology. 2016;14(2):175-82.e3.
