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By Jill Weisenberger, M.S., R.D., C.D.E., Lifescript Nutrition Expert
Published December 16, 2009
Just because heartburn is common doesn’t mean it can’t be cured. Left untreated, frequent acid
reflux can develop into more serious health problems. Here are the dos and don’ts of taming the
Despite humorous commercials with funny words like “plop-plop” and “fizz-fizz,” heartburn is no
joke. More than 60 million Americans suffer from it at least occasionally, according to the American
College of Gastroenterology.
Heartburn, also known as acid indigestion, occurs when acidic stomach juices flow backward into the
esophagus, irritating the esophageal lining. The resulting pain can be uncomfortable, annoying or
“It can hurt as much as a heart attack,” says Paige Hastings, a certified nurse practitioner at The
Little Clinic in Nashville, Tennessee.
But not everyone has such pain; you could also feel a bitter or acidic taste in the back of your throat
or the sensation of food or liquid washing back into your mouth and down the gullet.
In fact, frequent heartburn (two or more times a week) and food sticking in the throat are signs of
gastroesophageal reflux disease (GERD).
Untreated, these problems can lead more serious problems, including strictures (narrowing or
obstruction of the esophagus), ulcers, cancer and pneumonia, explains Patricia Raymond, M.D., a
gastroenterologist based in Virginia Beach.
“You can also become hoarse, because acid burns the vocal cords,” she adds. Asthma also is a
possibility, “because of spasms in the bronchial tubes.”
Before your heartburn goes from bad to dire, learn how to treat the symptoms. Read on for important
dos and don’ts about heartburn:
1. Understand causes of heartburn and GERD.
Under normal circumstances, the valve between your esophagus and stomach – the lower esophageal
sphincter (LES) – acts as a gate to block stomach acid from traveling back into the esophagus. With
GERD, the valve relaxes too much, allowing stomach contents to flow the wrong way.
If you’re pregnant, elderly or have a hiatal hernia – a condition in which part of the stomach is pushed
through your diaphragm and into the chest – you’re more likely to have heartburn or GERD.
2. Eat small portions and eat them slowly.
Large meals bring on large amounts of acid. Stuffing your stomach also adds abdominal pressure and
increases acid reflux.
15 Dos and Don’ts of Heartburn
HEALTH | BODY | LIFE | SOUL
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If you typically chow down on super-sized portions, shave off at least 20%. Smaller portions help you
lose weight, taming symptoms even further.
If weight isn’t a problem and your portions seem just right, try splitting your three meals into five or
Instead of eating a sandwich, fruit and salad for lunch, eat just the sandwich and salad and stash the
fruit for snack later.
3. Add more fiber to your diet.
The more fiber you eat, the less likely you’ll have GERD, says registered dietitian David Grotto,
author of 101 Optimal Life Foods (Bantam, 2009).
The Institute of Medicine, the health arm of the National Academy of the Sciences in Washington,
D.C., tells women to consume 25 grams daily. (For men, it’s 38 grams.)
Unfortunately, most Americans aren’t listening; our average intake is 15 grams a day. Here are some
easy ways to boost fiber intake:
Swap processed foods for whole foods. Eat the apple instead of drinking juice.•
Cook brown rice or barley instead of yellow rice pilaf.•
Eat one small serving of whole grains with each meal.•
Enjoy a variety of at least 1.5 cups of fruits and 2.0 cups of vegetables every day.•
Add chickpeas, kidney beans and other beans to soups and salads.•
Add dried fruit to muffin and pancake batter.•
Sprinkle a few nuts on salads.•
Mix wheat germ or ground flax seed into oatmeal.•
4. Seek out a few special foods.
“Apples, cranberries and cardamom can help heartburn,” Grotto says. The tiny red berry and sweet
spice have antibacterial properties, which may lower your risk of stomach ulcers caused by the
bacterium H. pylori, he explains. Apples are also high in pectin, a type of fiber, and the more fiber,
the less reflux.
Blackberries are another go-to food, he says, because they contain compounds that help heal the
Put carrots and kale on your list. Their beta-carotene and other nutrients can help repair acid-
5. Listen to your symptoms.
Studies show that acidic and spicy foods don’t appear to increase gastric acid. Nonetheless, some
heartburn sufferers say that spicy foods, tomato products and citrus trigger problems. If that’s your
case, eliminate them from your diet on a trial. Otherwise, cutting them out robs you of some
“There needs to be a real emphasis on individualization,” says Grotto, who successfully treated his
own GERD several years ago. “I tolerated spicy foods just fine,” he says.
So he increased fruits, veggies, whole grains and fiber and cut back on alcohol and coffee.
“I practiced what I preached — and it worked,” he adds.
6. Drop a few pounds.
Lugging extra weight increases abdominal pressure and strains the lower esophageal sphincter.
Even normal weight woman are more likely to experience GERD’s pain and discomfort if they gain a
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few pounds, researchers reported in a 2006 issue of the New England Journal of Medicine.
Hormones secreted by body fat may trigger some of the symptoms, the researchers speculated.
7. Act like a detective.
You’re feeling the burn, but was it chocolate, coffee, mints, pizza or something else that triggered it?
The foods and conditions that cause your pain probably aren’t the ones affecting friends and
To find out what your triggers, keep a heartburn journal, says Eileen Myers, a registered dietitian in
private practice in Nashville and author of a GERD treatment program for nurse practitioners.
Record symptoms, their severity and possible causes. Pinpoint what you ate or drank, how fast and
Then, look for trends. A small notebook will do, but you can find a journal in the Get Heartburn Smart
brochure at the National Heartburn Alliance (NHBA) Web site.
8. Find out if medication is to blame.
Both prescription and over-the-counter medications can affect the LES or increase acid production,
Drugs that treat high blood pressure, asthma, inflammation and osteoporosis frequently fan the
heartburn flame, she says.
If you suspect a drug is aggravating symptoms, ask your doctor for possible alternatives. But don’t
stop taking prescription medications without checking with a physician.
1. Don’t rev up acid production.
“If you drink alcohol, stop,” Myers says.
Give up red and black pepper and coffee — even decaf — for a few weeks to see if that brings relief.
Each can increase gastric acidity.
2. Don’t smoke.
As if you needed another reason to quit! According to the NHBA, smoking inhibits production of saliva,
one of your body’s natural protective barriers against insults to esophageal lining.
Smoking is a triple offender because it might also pump up acid production and weaken the LES.
3. Don’t eat after-dinner mints.
Get rid of everything that’s an enemy to the LES, Myers says.
Just say no to spearmint, peppermint and other foods that decrease LES function by triggering the
release of hormones or affecting chemical pathways allowing the sphincter to relax and food to wash
Start with a trial elimination of mint, chocolate, caffeine and high-fat foods, such as baked goods,
marbled meats, full-fat dairy and fast-food value meals.
4. Don’t wear tight clothing.
It’s more than just uncomfortable: Squeezing into too-tight clothing also increases abdominal
pressure, just like a large meal does.
5. Don’t eat before bed.
No lying down before digesting your meal. Finish eating 2-3 hours before snoozing.
“It’s the whole gravity thing,” Raymond explains. “Stuff can flux back up because you’re horizontal
instead of vertical.”
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