Heartburn is something most people associate with overeating, such as that post-Christmas dinner feeling.
And yes, big meals are a major cause – but sometimes the problem can be in less obvious triggers, like wearing tight clothes (too tight belts, high-waisted jeans or even bras), constipation or bloating.
How does any of this relate to your heart, you may ask. Actually, heartburn has nothing to do with the heart, but it is about your esophagus (or food pipe).
Heartburn is a common symptom of acid reflux. This happens when stomach acid and other stomach contents travel the wrong way and back up into your esophagus through the trapdoor (the esophageal sphincter, a circular ring of muscle that acts as a gateway between your esophagus and the acid-filled stomach).
Heartburn is something most people associate with a lot of food, like that classic after-Christmas dinner feeling
Unlike your stomach, your esophagus isn’t built for harsh acids, and it causes a nasty burn just behind your breastbone—that’s heartburn.
When you fill your stomach in one sitting, it creates uneven pressure between the stomach and the esophagus, and essentially raises the trapdoor.
Tight clothing can also cause this type of pressure imbalance, as can constipation.
But if you experience heartburn and/or reflux at least twice a week and it’s not related to overeating, tight clothing or constipation, you may have gastro-oesophageal reflux disease (GORD).
This common condition affects more than ten percent of adults. The causes vary — some people are genetically more susceptible to reflux, for example, they may have a weak oesophageal sphincter; Others may have physical causes such as a hiatus hernia (where part of your stomach pushes up through the diaphragm).
Do you know?
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But not all chronic heartburn is caused by acid reflux – in fact, it’s believed that in four out of ten people, the symptoms are caused by a sensitive gut as a result of miscommunication between the gut and the brain.
The first-line medical treatment for acid reflux is proton pump inhibitors (PPIs), which suppress the production of stomach acid.
However, various studies have estimated that these drugs (even at high doses) do not provide adequate relief in 10 to 40 percent of patients with suspected GORD.
And when you test such ‘non-responding’ patients, the acid level (ie pH) tests usually come back normal, even though they have very real symptoms.
This type of heartburn, where there is no clinical explanation or abnormal test results, is called a ‘functional’ oesophageal disorder – structurally, everything is normal but it is like a display house, where everything seems to be in the right place, but. Fridge not turned on (irritable bowel syndrome is another form of functional disorder).
If you’ve been prescribed PPIs and they don’t help, don’t assume you need a stronger prescription – you may have functional heartburn, which means you’re taking the medication unnecessarily and, like all medications, PPIs have potential side-effects over time.
For example, long-term use is associated with a higher risk of vitamin B12 deficiency (stomach acid is needed to release B12 from food). This in turn can lead to problems such as fatigue and in severe cases, especially in elderly people, neurological damage.
PPIs also affect your gut microbiota, a colony of microbes vital to our health. In fact, PPIs have been shown to increase the risk of stomach infections (our stomach acid normally kills pathogens and creates a healthy environment to promote the right balance of microbes and defend against invasion).
But there are several key diet and lifestyle strategies that can help you get on top of your heartburn and reflux.
The evidence behind most of these strategies is, admittedly, limited in terms of good-quality trials—by which I mean studies where treatments are tested in a controlled setting, such as a clinic.
However, observational studies (where people are observed in their normal environment) and expert consensus support trying these strategies before turning to medication.
Here are my suggestions for things you can implement right now to make a difference:
- Avoid large meals. Divide meals into small portions, eating five or six times throughout the day.
- Allow at least three hours between the last meal of the day and bedtime. This ensures that most of your food moves through your stomach and thus reduces the pressure on your oesophageal sphincter.
- Identify your triggers. Keep a seven-day food and symptom diary and look for any patterns between foods, lifestyle factors (such as stressful days) and your symptoms.
Commonly reported dietary triggers include high-fat foods (such as deep-fried foods and pastries—switch to grilled and wholegrain options); fizzy drinks and citrus fruit or juice (swap for herbal teas like ginger); spicy foods (swap for cayenne or other flavoring herbs, such as smoky paprika or turmeric); tomatoes; Chocolate, caffeine (opt for decaffeinated drinks); and alcohol.
Many of these commonly reported triggers have been shown to affect pressure at the oesophageal sphincter.
- Avoid tight clothing – and that includes belts! Think about balancing that sphincter pressure.
- If you get reflux in bed or while lying down, try sleeping on your left arm. Since the esophagus is attached to the right side of the stomach, sleeping on the left side prevents acid from being pushed back up.
- Elevate one side of your bed 10 cm to 20 cm so that your head and chest are at a level just above the waist — this helps reduce the pressure that can cause the oesophageal sphincter to open again. And the following long-term strategies can help, too:
- Keep your weight under control – High body weight is linked to a higher risk of reflux. It’s that oesophageal sphincter, again – extra weight puts pressure on it. For example, a 2014 US study of overweight people (with an average BMI of 35) found that weight loss improved their symptoms, with 65 percent seeing their symptoms disappear completely.
- For the same reason, constipation and bloating can also worsen reflux — see my column on how to cope last week (I’ll write about bloating soon).
- Stop smoking. Yes, I know, easier said than done, but a 2016 study from Japan’s Osaka City University found that people who quit smoking for a year had about a 50 percent improvement in their GORD symptoms.
Of course, if you need medication, you need it – it’s all about weighing the pros and cons.
For those who are tempted to just ignore the symptoms, it is important to be aware that chronic reflux is not only burdensome in terms of discomfort but can also increase the risk of diseases such as oesophageal cancer. So whatever path you decide to take, it’s important to get on top of it.
Note: If you have any of the following red flags, talk to your GP straight away:
- any lumps or tenderness in your throat or abdomen;
- A family history of either oesophageal or stomach cancer.
Try this: Avocado Ice Lolly
Fiber-filled ice lollies to keep you (and those bacteria in your gut) thriving during this heat wave.
- 2 ripe avocados
- 240 ml coconut milk
- 2 tablespoons of honey
- 2 kiwis, cut into pieces
- 60 grams of frozen raspberries
- 1 teaspoon chia seeds
- Juice of half a lemon
- 2 tablespoons water, if necessary to loosen the mixture
Place everything in a blender, except the raspberries, and blend until smooth. If the mixture seems too thick, add additional water. Add the raspberries to the mixed mix, pour into the moulds, add the lolly sticks and freeze until firm (which will take about four hours).
I’ve been struggling with my gut health – it starts with colds, headaches, gut cramps and then hunger and fatigue. It lasts for a few days at a time and is happening more regularly than before. It’s really dragging me down.
John Watkins, Swansea.
Although many of these symptoms are ‘non-specific’ – meaning that many different things can trigger them – the collection you describe is particularly common in ‘dumping syndrome’.
This happens when food moves quickly from your stomach to your small intestine. As a result your intestines produce more hormones than normal and your intestines can swell with extra fluid, triggering a cascade of symptoms similar to yours.
This usually occurs after abdominal surgery but I have also seen it in people with recently developed diabetes or pancreas problems. I recommend discussing your symptoms with your GP. In terms of diet management, try:
Eat smaller meals, more often – instead of three large meals, divide your meals evenly into five meals.
Limit foods high in added sugar such as breakfast cereals (try oatmeal) and fizzy drinks (try sweetened soda water with squashed fresh fruit).
Eat more slowly. Aim to chew at least 20 times per mouthful.
Contact Dr. Megan Rossi
Email [email protected] Or write to Good Health, Daily Mail, 2 Derry Street, London W8 5TT — please include contact details. Dr Megan Rossi cannot enter into personal correspondence.
Answers should be taken in general terms; Always consult your GP with any health concerns.
Source: | This article is originally from Dailymail.co.uk