Steps for Heartburn

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Heartburn, that uncomfortable burning sensation that radiates up the middle of the chest, is the most common digestive malady. It’s the result of a condition known as gastroesophageal reflux disease (GERD), often called reflux, in which stomach acid surges upward from the stomach into the esophagus.

While heartburn should not be ignored, there are many stomach-soothing steps you can try before going to a doctor. These can help cool your symptoms and prevent bigger problems later on.

Eat smaller meals, but more often. A full stomach puts pressure on the lower esophageal sphincter (LES), a valve-like muscle that keeps stomach acid from backing up into the esophagus.

Eat in a slow, relaxed manner. Wolfing down your food fills your stomach faster, putting more pressure on the LES.

Remain upright after meals. Lying down increases pressure on the LES, which makes acid reflux more likely.

Avoid late-night eating. Eating a meal or snack within three hours of lying down to sleep can worsen reflux and heartburn symptoms. Leave enough time for the stomach to clear out.

Don’t exercise immediately after meals. Give your stomach time to empty; wait a couple of hours after eating before exercising.

Tilt your torso with a bed wedge. Raising your torso up a bit with a wedge-shaped cushion reduces the pressure on the LES and may ease nighttime heartburn. Wedges are available from medical supply companies. Don’t just prop your head and shoulders up with pillows, which can actually worsen reflux.

Stay away from carbonated beverages. They cause belching, which promotes reflux of stomach acid.

Find the foods that trigger your symptoms and avoid them. Some foods and drinks increase acid secretion, delay stomach emptying, or loosen the LES — conditions that set the stage for heartburn. Common offenders include fatty foods, spicy foods, tomatoes, garlic, milk, coffee, tea, cola, peppermint, and chocolate.

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 flavors, which may trigger heartburn.

Check your medications. Ask your doctor or pharmacist about drugs that can cause pain resembling heartburn. Some drugs, for example, can loosen the LES and cause acid reflux. Other drugs can cause inflammation of the esophagus.

Lose weight if you need to. Being overweight puts more pressure on the stomach (and the LES).

If changing your eating habits and other preventive steps don’t get heartburn under control, talk with your doctor. She or he can advise you on which medications to try and recommend additional follow up if necessary.

www.health.harvard.edu