Most people are familiar with the uncomfortable feeling in the upper part of the digestive tract, called heartburn or acid indigestion.
What is heartburn?
It is a burning sensation in the throat, chest or upper abdomen that often occurs after eating, and is also a common symptom of Gastro Oesophageal Reflux Disease (GORD or GERD).
What causes heartburn?
At the end of the oesophagus (the tube that carries food from the mouth to the stomach) there is a valve (called the lower oesophageal sphincter) that normally keeps the acid and digestive juices in the stomach.
Heartburn occurs most commonly after eating a large meal as an over full stomach alters the pressure on the lower oesophageal sphincter. This altered pressure causes the sphincter to close inadequately, resulting in acid flowing up into the oesophagus.
Being overweight may also contribute to increased pressure in the region and cause the lower oesophageal sphincter to malfunction. In addition, high-fat and fried foods are digested or broken down more slowly, which can lead to increased stomach acid production. This increases the probability of the stomach contents pushing back up into the oesophagus.
Additional causes or aggravators of heartburn include stress, pregnancy, certain medications and smoking.
Managing and preventing heartburn
Knowing your triggers can help prevent and manage heartburn. This is important because over time reflux can damage the oesophagus, resulting in chronic inflammation.
- Small meals. Eat smaller portions at mealtimes and avoid second helpings. If the meal does not keep you satisfied, incorporate a small snack in between. You can try to eat four to five small meals instead of three large meals.
- Eat slowly. Take your time – don't rush. Try putting your fork down between bites and chew your food thoroughly.
- Avoid commonly known heartburn triggers. The following foods and drinks can potentially trigger your heartburn symptoms and should be avoided. They include: onions, peppermint sweets, chocolate, caffeinated beverages like coffee and tea, fizzy cold drinks, citrus fruits or juices, tomatoes, spicy foods or high-fat or fried foods. Examples of spicy foods are: chili and jalapeno peppers, curries and sauces made with masala, curry powders, and chilies. Examples of high-fat products are: butter, cream, oils, margarine, salad dressings, sauces, or high-fat foods such as pies or pastries, muffins, biscuits, ice-creams, cakes, Fast foods to avoid are: deep fried fish or chips, “vetkoek”, pizzas, "prego rolls" and "bunny chows". (Not all individuals experience heartburn from the same foods, and a good way to establish which foods cause your symptoms, is to keep a food and heartburn diary.)
- Alcohol. Avoid alcohol. If your aim is to unwind after a stressful day, try things like exercise, walking, meditation and stretching.
Other ways to manage heartburn
- Stop smoking. The nicotine in cigarettes can lower or weaken the lower oesophageal sphincter.
- Stay upright after meals. Avoid going to bed with a full stomach. Eat meals at least two to three hours before lying down. This will give the food time to digest and leave the stomach.
- Wear loose-fitting clothes, especially around the abdominal area.
- Aim to achieve and maintain your ideal body weight.
Avoid heartburn this Easter
Natural history of heartburn
Cresci, G and Escuro, A. (2016) Krause’s Food and the Nutrition Care Process. Chapter 27, pages: 508-515
Duyff, RL. (2012) Complete Food and Nutrition Guide. Chapter 22; pg. 619-621.