Heartburn is one of the most common medical conditions experienced by upwards of 40% of Americans on a monthly basis. Sixty million or more Americans have heartburn once a week. It occurs when a faulty valve (lower esophageal sphincter) responsible for keeping acid-containing food in the stomach fails to do its job and acid-laden contents are allowed to reflux into the esophagus (food tube). If heartburn persists, it can lead to gastroesophageal reflux disease (GERD).
Acid reflux, or heartburn, can happen when there is large amount of pressure in the stomach (such as after a big meal) or if the valve at the lower esophageal sphincter becomes inappropriately weak after consuming certain substances (caffeine, chocolate, alcohol, etc.) Frequently, both mechanisms of action are the cause. When reflux occurs, the lining of the esophagus is not designed to handle this displacement of acid and it can become irritated and that irritation causes heartburn.
One frequently unappreciated fact is that there are two faces of heartburn as to how it presents. The typical (classic) symptoms and atypical symptoms for heartburn are:
- Burning breast-plate (sternal) chest pain; increased by bending or lying down, worse at night, and relieved by antacids
- Food sticking after swallowing behind breast plate
- Acid in back of throat/sour taste on awakening
- Upper abdominal pain
- Temporary relief obtained with off-the-shelf antacids
- Postnasal drip
- Persistent cough
- Lump in throat
- Raspy or hoarse voice
- Noncardiac chest pain
Whether you have typical or atypical symptoms, reflux is a health issue that you cannot ignore. It is imperative that you realize that all heartburn is not created equal. You must work with your doctor to quickly assess your symptoms and determine if you have reflux or something more serious called gastroesophageal reflux disease (GERD). Frequency of symptoms can be an important risk factor for diagnosis for GERD. About 3% to 7% (9-21 million) of Americans have reflux every day and, unfortunately, the incidence is rising. About 22% of the primary-care visits in this country involve GERD symptoms. Over the last seven years, this is an increase of 46%.
The prolonged presence of acid in the esophagus leads to complications that can produce a range of problems from annoyance to a potentially fatal condition.
The following are the complications that can occur with GERD:
- Erosive esophagitis
- Esophageal ulcers
- Esophageal strictures
- Aspiration pneumonia and asthma
- Poor quality of life
- Barrett's esophagus (and this can lead to esophageal cancer in a small percentage of cases)
In light of the potential negative impact of the above complications on your life, you must take this condition seriously. You do not want to think that you are a heartburn sufferer that is actually a GERD hostage and then turn into an esophageal cancer victim.
Diet and Lifestyle Change: The First Line of Defense
The good news is, most people who have heartburn can manage symptoms on their own. Lifestyle and dietary changes can be the first line of defense. These include
(1) Changing what you eat
(2) Changing when and how you eat
(3) Elevate the head of your bed to help avoid nighttime symptoms
(4) Weight loss
We are in a war against heartburn, and the American diet is full of land mines that cause us to suffer. It is high in heavy, fat-laden meats, carbs and processed foods. Most notably, there is not a good balance between the bad (acid-promoting) foods that cause heartburn and the good (alkaline-promoting) foods that help to prevent heartburn. What can you do? Strive to balance your culinary equation by pursuing a more alkaline diet.
Good (Alkaline-Promoting) Foods
- Grilled and baked meat
- All veggies
- Breads, rice, oatmeal
- Alkaline water, soy and coconut milk
- Chamomile tea
- Manuka honey
Bad (Acid-Promoting) Foods
- Carbonated and citrus beverages
- Canned foods (heavy acid for preservation)
- Raw tomatoes
- Breath mints