Managing heartburn

Ishi Khosla is a former senior nutritionist at Escorts. She heads the Centre of Dietary Counselling and also runs a health food store. She feels that for complete well-being,one should integrate physical,mental and spiritual health. According to her: To be healthy should be the ultimate goal for all.

After a rich feast of fried snacks,alcohol and oily curries late into the night,it is not surprising if you are unable to sleep. It may be either because of pain in the stomach or discomfort in the chest. Most reach out for the antacid,which helps recovery. This is one of the most common presentations of what is called GERD Gastro-esophageal Reflux disease or simply acid reflux.

GERD is caused by frequent acid reflux the backup of stomach acid or bile into the esophagus. Common digestive disturbances include heartburn burning sensation in the chest,sometimes spreading to the throat,along with a sour taste in the mouth,hiccups,nausea after eating,regurgitation of food or feeling of food being trapped in the stomach. These often happen due to reflux which causes irritation in the esophagus when the stomach contents food or liquid move backwards from the stomach into the esophagus.

Once food is in the stomach,a ring of muscle fibers protects the esophagus by preventing food from moving backward into the esophagus. These muscle fibers are called the lower esophageal sphincter,or LES. If this sphincter muscle doesnt close well,food,liquid,and stomach acid can leak back into the esophagus and cause Gastroesophageal reflux disease GERD. GERD can also manifest as chronic sinusitis,nocturnal choking,sensation of a lump in the throat,chronic hoarseness,dry cough,soar throat and asthma,to name a few. Epidemiological evidence suggests that 34-89 per cent of asthmatics have GERD irrespective of the use of bronchodilators.

While chest pain and choking are common symptoms of GERD,seek medical advise if these are accompanied by shortness of breath or jaw or arm pain,as these may be signs and symptoms of a serious cardiac problem or a heart attack.

Gastroesophageal reflux disease GERD is a common condition affecting 30 to 40 of adults. It also occurs frequently in infants,typically beginning at birth. Infants present with vomiting,irritability,lack of appetite,and sometimes symptoms of chronic aspiration. Infants with chronic aspiration may have cough,hoarseness,or wheezing.

Common contributing factors of GERD include over-indulgence in rich and spicy food,late-night eating,large meals,carminatives peppermint,spearmint oils,garlic,onions and cinnamon,excessive indulgence in chocolates,tea and coffee,excessive alcohol,smoking and prolonged medication like antibiotics,sedatives,antidepressants,beta-blockers and calcium channel blockers for high blood pressure or heart disease,bronchodilators for asthma,steroids,and many others. Hormonal therapy like progestin for abnormal menstrual bleeding or birth control,drugs for seasickness and Parkinsons disease also may induce GERD symptoms.

Obesity,metabolic syndrome,hiatus hernia,increased stress,lack of sleep,frequent travel,pregnancy and ageing may also contribute to GERD. In a meta-analysis,overweight or obesity was closely associated with GERD symptoms. There is also a relationship between visceral adiposity abdominal fat and GERD. Presumably the increased visceral fat leads to increased intra-abdominal and intra-gastric pressure,resulting in a predisposition for hiatal hernia and thus GERD.

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Lifestyle changes can play a major role in GERD management:

Maintain a healthy weight. Excess pounds put pressure on the abdomen,pushing up the stomach and causing acid to back up into the esophagus.

Avoid large meals,especially late into the night.

Avoid excessive intake of non-vegetarian food and junk food. Include plenty of vegetables and fruits.

Avoid foods and drinks that trigger heartburn. Individuals have specific triggers. These may include fatty or fried foods,excessively sweet foods,citrus fruits,tomatoes,wheat,alcohol,chocolate,mint,garlic,onion,caffeine,fermented foods.

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Avoid very hot or very cold foods,as they may induce esophageal spasm.

Limit alcohol and avoid smoking as it tends to decrease the lower esophageal sphincters ability to function properly.

Chew gum,which will stimulate acid-neutralizing saliva.

Avoid tight-fitting clothing. Clothes that fit tightly around your waist put pressure on your abdomen and the lower esophageal sphincter.

Avoid exercising or bending over just after eating.

Elevate the head of your bed. If you regularly experience heartburn at night or while trying to sleep.

Regular physical exercise and yoga will help in digestion