That basket of chili cheese fries seemed like a delicious idea at the time. But now you’re being haunted by the Ghost of Cheese Fries Past — and it’s not pretty.
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Despite its name, heartburn has nothing to do with your heart. But the “burn” part? Yeah, that’s accurate. Heartburn feels like a scorching sensation in the center of your chest. And you might be feeling it because you have acid reflux.
Want to quench the flames? Gastroenterologist Scott Gabbard, MD, explains what causes heartburn and how to take control.
What is GERD?
Anyone can get heartburn occasionally. It occurs when swallowed food or stomach acid backs up into the esophagus. But if heartburn haunts you regularly, you might have gastroesophageal reflux disease, or GERD, a kind of chronic acid reflux.
Blame the lower esophageal sphincter, a ring of muscle between your esophagus and stomach that’s supposed to close after food passes through. In people with GERD, the sphincter doesn’t close properly, and stomach acid regularly scoots up where it doesn’t belong. GERD usually makes itself known after you eat, exercise, bend over or lay down at night.
That acid backflow causes the familiar burn, as well as hoarseness, dry cough, chest pain or the irritating sensation that something is stuck in your throat.
That discomfort is bad enough. But long-term, untreated GERD can damage the esophagus and increase the risk of esophageal cancer. Never fear: There are steps you can take to rein in the reflux.
Lifestyle changes for heartburn symptoms
If acid reflux is bringing you down, Dr. Gabbard recommends giving these lifestyle changes a shot:
- Drop a few pounds. Extra weight can force acid up into the esophagus and put pressure on the esophageal sphincter, causing it to open up when it shouldn’t. Losing weight isn’t the easiest change to make, but it’s the single biggest thing you can do to reduce acid reflux, Dr. Gabbard says.
- Skip the all-you-can-eat buffet. Big, fatty meals are fuel for heartburn. Try eating smaller, more frequent meals instead. “Limiting meals to 500 calories and 15 grams of fat does seem to limit the amount that the sphincter opens, so staying below those values seems to be good for patients who have heartburn after meals,” Dr. Gabbard says. (Chili cheese fries, for reference, can pack 570 calories and 30 grams of fat.)
- Stop smoking. There are all sorts of good reasons to steer clear of tobacco, of course. Add heartburn to that list: Nicotine can weaken the esophageal sphincter. Quitting smoking has been shown to improve GERD symptoms.
- Get up, stand up. Give yourself a chance to digest before you lay down. “Remain upright for at least two hours after all meals,” Dr. Gabbard recommends. (Apologies to your post-Thanksgiving nap.)
- Work the angles. Sleeping on an incline can ease nighttime reflux. Try placing blocks under the head of your bed or using a wedge-shaped pillow.
- Know your triggers. Most people with GERD find certain foods make symptoms worse. But problem foods can differ from person to person, so don’t assume you have to swear off pizza forever. Keep a food log to identify what foods or drinks cause you grief. (Common triggers include alcohol, chocolate, coffee, citrus, tomatoes and fatty foods.)
Medicines for heartburn relief
If you’ve adopted healthier habits and are still dealing with heartburn, a variety of medications are available over the counter to help control your symptoms. Calcium carbonate antacids (like Tums® and Rolaids®) neutralize stomach acid. Other medications, such as omeprazole (Prilosec®) and famotidine (Pepcid®), decrease the amount of acid the stomach produces.
But even if you opt for these over-the-counter medicines, it’s still a good idea to talk to your doctor about your heartburn. He or she can rule out other problems and make sure you’re using the best medication for your symptoms.
Long-term use of antacids may rarely lead to problems such as vitamin and mineral deficiencies, so definitely loop in your physician if you’re popping daily tablets.
For a small percentage of patients, lifestyle changes and medications aren’t enough. Those folks can benefit from surgery called fundoplication, which tightens the sphincter between the stomach and the esophagus.
The bottom line? Heartburn is a common problem. That might not feel like good news when you’re tossing and turning in bed, feeling like a fire-breathing dragon, but it means that doctors have a lot of experience dealing with reflux — and a lot of options to help you find relief.