Image credit National Cancer Institute

Heartburn results from the backwash of stomach acid into the esophagus, the tube connecting the mouth and stomach.  Its medical term is gastroesophageal reflux disease (GERD).

“Heartburn can cause damage to the esophagus and even increase the risk of cancer if ignored and untreated,” warns Dr William Kormos, editor in chief of Harvard Men’s Health Watch and a primary care physician at Massachusetts General Hospital.

8 steps to ease heartburn:

1.  Eat in a smart way.  Eat smaller, more frequent meals, and don’t wolf down food.  Large meals put pressure on the muscle that prevents the backwash of acid into the esophagus.  The longer you eat, the longer it takes for the stomach to empty, thus contributing to reflux.

2.  Avoid eating late at night.  Leave enough time for the stomach to empty out.

Consuming food within three hours of lying down to sleep worsens GERD.

3.  Avoid exercise right after meals.  Wait a couple of hours to give your stomach time to empty.  But don’t lie down.

4.  Sleep on an incline.  Use a wedge-shaped cushion, available at medical supply companies and some home goods stores, to raise your torso up a bit.  Propping up just your head and shoulders with pillows increases pressure on the stomach by curling you up at the waist.

5.  Avoid foods that trigger heartburn.  Those to avoid include fatty or spicy foods, tomatoes, garlic, milk, coffee, tea, cola (carbonated beverages cause belching), peppermint and chocolate.

6.  Chew sugarless gum after a meal.  Chewing gum promotes salivation, which neutralizes acid, soothes the esophagus and washes acid back down to the stomach.  Avoid peppermint, which may trigger reflux.

7.  Rule out side effects from medication.  Check with your doctor or pharmacist to rule out any medications you’re taking that might contribute to heartburn.

8.  Lose excess weight.   Excess weight puts excess pressure on the stomach, pushing its contents up into the esophagus.  Similarly, tight-fitting clothing and belts may also be factors.

When to consider medication

If the above lifestyle changes don’t control heartburn, try a type of drug called a proton pump inhibitor (PPI).  It drastically reduces the stomach’s acid secretion.  Some PPIs are available over-the-counter, PPIs such as lansoprazole (Prevacid) and omeprazole (Prilosec).

But don’t take a PPI indefinitely because research links the medication to increased susceptibility to bacterial infection and long-term risk of hip fracture.

After taking a PPI to control heartburn symptoms, ask your doctor about tapering off and combining good preventive measures with the use of other medicines.  H2 blockers are good choices and include cimetidine (Tagamet), ranitidine (Zantac), famotidine (Pepcid), and nizatidine (Axid).

My Take on the treatment of heartburn:  All medicines have side effects.  The side effects of the 8 recommended steps are a drug-free and possibly longer life.

I’m not advocating eliminating medication, but I always try to modify my life-style choices to promote better health and consider medication a welcome last resort–if necessary.

Source:  Harvard Medical School Healthbeat, November 3, 2012


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