Tips for Frequent Heartburn Sufferers


If you're prone to frequent heartburn symptoms, there are lots of simple things to try before you see your doctor. If one of more of these solutions works for you, great! If not, make an appointment to discover if your heartburn is really a symptom of a more serious condition.

1. Adopt a high-fiber diet.
Fiber is your friend when you have chronic heartburn since it helps speed up the digestion process. In some studies, soluble fiber has been linked to lower levels of stomach acid production. And fiber feeds healthy intestinal bacteria, too. Whole grains contain more gut-friendly fiber than refined ones, so make an effort to make most of your grains as unprocessed as possible. Swap out white rice for brown rice, and choose whole-grain varieties of your favorite pastas, breads and cereals. Fill your plate with fiber rich veggies, fruits and beans, too. Add fresh spinach to soups and sauces, and try serving meat with a side of lentils instead of potatoes. A large increase in fiber over a short period of time could result in bloating, diarrhea, gas and all-around discomfort, so it's better to add fiber to your diet gradually over three weeks, to avoid problems.

2. Eat smaller, more frequent meals.
Many people who experience chronic heartburn have a weakened lower esophageal sphincter (LES). When you eat too much at one time, the LES will have a harder time preventing food and stomach acid from backing up into your esophagus. Instead of the traditional "three squares a day," try eating six times a day. This doesn't mean that you should eat twice as much food; each "mini" meal should be about half the size of your typical meals and still include a low-fat protein source and a good source of fiber to aid in digestion and keep stomach acid levels as consistent as possible. Smaller more frequent meals may also aid weight loss, which can further reduce your heartburn symptoms.

3. Eat slowly.
Researchers at the Medical University of South Carolina in Charleston fed 690-calorie meals to 10 healthy volunteers, instructing them to finish the meal in either five or 30 minutes on alternating days. Participants were monitored for two hours after finishing their meals. Those who took 30 minutes to eat experienced fewer episodes of acid reflux or heartburn compared to subjects who finished eating in five minutes. Most people need to work on slowing down many areas of their lives, and mealtime is a perfect place to start. Besides aiding your digestion, eating your meals slowly can help your waistline too, by giving your stomach a chance to communicate to your brain that it’s full. Time yourself, just to see how long it takes you to eat an average meal. Try to take a full 20-30 minutes (you might have to build up to this slowly) to finish your food.


4. Avoid high-fat meals.
Fatty cuts of meat like steak, lamb, poultry with the skin and certain cuts of pork wreak havoc on heartburn-sufferers because fat takes longer to digest and causes your stomach to produce extra acid. Some of the best meat choices for people with heartburn are the leanest cuts: chicken (with the skin removed), lean ground turkey and lean ground beef, fish and pork tenderloin. Creamy sauces and other high-fat dairy products will aggravate heartburn, too. But that doesn't mean you have to give up on your favorite creamy dishes! Instead of heavy cream and full-fat milk or yogurt, try using low-fat or fat-free versions. (Low-fat Greek yogurt makes a great substitute in creamy sauces, dips and spreads.) When cooking, avoid deep frying and opt for baking, broiling or grilling, instead.

5. Remain upright for a least 30 minutes after eating.
Gravity is your friend when you have heartburn. Remaining in an upright position after eating allows the stomach acid to stay where it's supposed to be so it can digest your food without backing up into your esophagus. So don't be tempted to lay down on the couch after lunch on a lazy Sunday afternoon. You're likely to wake up with a burning sensation in your chest! Even better, consider going for a gentle walk around the block after meals, but keep it slow and steady. Vigorous exercise too soon after eating can exacerbate heartburn symptoms.

6. Wait 2-3 hours after eating before vigorous exercise.
Make sure your food has had a chance to fully digest before you hit the gym for a serious workout. Exercising on a full stomach increases abdominal pressure that can force food and acid into the esophagus. Certain exercises can also increase the pressure, particularly sit-ups, crunches and other abs exercises. Even gentle exercises like yoga, can induce heartburn if you do any inversions (like handstand or plow) or allow your head to come below your heart (such as downward facing dog or forward bend). If you need to eat before a workout, keep your snack small, low in fat and easy to digest. Good choices include a banana, a fruit smoothie or a small handful of pretzels.

7. Quit smoking.
Do you really need another reason to quit smoking? Smoking affects heartburn in several different ways. Studies show that the nicotine in tobacco tends to reduce the pressure within the lower esophageal sphincter (LES), which connects the esophagus and stomach. This allows stomach acid to wash back up into the esophagus, causing heartburn. Smoking also increases acid production in the stomach, increasing reflux flares. Finally, cigarette smoke can irritate and damage the lining of the esophagus, which then reduces protection against stomach acid.


8. Avoid drinking alcohol in excess.
The lower esophageal sphincter (LES) normally prevents stomach contents from entering the esophagus. But alcohol is a depressant that relaxes the body in many ways; it also relaxes the LES, allowing acid to enter the esophagus. If you rely on an evening drink to relax, try herbal tea, stretching or meditation instead. If you're going to enjoy an alcoholic beverage, do it earlier in the evening, rather than right before bed. (And skip the acidic fruit juice mixers.)

9. Chew gum.
Chewing sugarless gum after meals can prevent heartburn by promoting the production of saliva, which aids digestion. Be sure to choose a non-mint flavor since mint can relax the LES making heartburn worse. A British study showed that chewing gum for 30 minutes after a meal significantly lowered stomach acid levels.

10. Drink water after meals.
A small glass of water at the end of a meal can help dilute and wash away any stomach acid that's trying to sneak up your esophagus. Just make sure to keep the amount small. Too much water will overwhelm the stomach and could cause more acid to back up into the esophagus.

11. Avoid caffeinated beverages.
Caffeine can increase stomach acid and some people are bothered by the carbonation in colas and other soft drinks. Research has not shown caffeine-free, carbonated beverages to be troublesome for most people with GERD. However, if you notice that you don't tolerate drinks with carbonation well, then skip the bubbly beverages.

12. Sleep in an elevated position.
No matter how long you wait to go to sleep after eating, if you have a weakened LES, spending a prolonged period of time lying flat on your back is likely to lead to reflux. If you're not lucky enough to have an adjustable bed, the easiest way to get into a heartburn-friendly sleep position is to elevate the head of your bed on cinder blocks. If you share your bed with someone else, this might not be a great option, though. Instead, you can use a special wedge-shaped pillow to elevate your head, shoulders and upper back. Be careful of trying to stack a couple of pillows. You might just end up elevating your head, which won't help prevent heartburn. Sleeping on your left side has also been shown to reduce nighttime heartburn symptoms.

This article has been reviewed and approved by Becky Hand, Licensed and Registered Dietitian.




Sources
Kahrilas, PJ and Gupta, RR. "Mechanisms of Acid Reflux Associated with Cigarette Smoking," Gut, 1990 January, 31 (1):4-10.