By Stephen T. Sinatra, M.D., F.A.C.C., F.A.C.N., C.N.S., C.B.T.
Ever hear of the LES – the lower esophageal sphincter? If you have heartburn, your problem is likely self-inflicted harm to your LES…
Heartburn actually has nothing to do with the heart and everything to do with your esophagus, the tube that carries food from your mouth down into the stomach. Heartburn develops when a ring-like muscle at the bottom of the esophagus – the LES – becomes weak or relaxes when it shouldn’t. The LES is supposed to keep stomach acid from rising up into the esophagus, but when it’s not sealing off the acid properly the sensitive lining of the esophagus will let you know in a hurry.
Common heartburn refers to burning discomfort that starts behind the breastbone and radiates upward to the neck and throat. Another related problem is acid regurgitation where you experience a bitter, sour tasting fluid. Experts say that one out of five people experience either of these symptoms on a weekly basis; two out of five at least once a month. Chronic symptoms can lead to esophageal tissue damage, permanent scarring, and a condition called gastroesophageal reflux disease (GERD) linked to an increased risk of asthma, pneumonia, and cancer.
Why is the LES not doing its job? There are a number of possibilities. They include obesity and pregnancy which put extra pressure on the stomach. Other common causes are overeating in general, overeating late at night, smoking, alcohol, caffeine, and aspirin.
Millions of people resort to antacids or drugs to counteract their heartburn. The pills suppress acid production or neutralize it. However, pills have side effects and are usually unnecessary because heartburn can often be controlled with some lifestyle and dietary changes.
Here are some natural ways you can beat heartburn:
- Eat a diet high in fiber. That means plenty of fruits and vegetables, as in my PAMM Diet.
- Sip a glass of warm water after eating to wash down any rising stomach acid. The water will also dilute the acid.
- Ginger is a great remedy that strengthens the holding power of the LES. If a slice of fresh ginger is too spicy, go instead for a cup of ginger tea (made fresh from grated ginger) once or twice a day. Let the ginger steep for at least five minutes.
- Don’t overeat. Stop eating large meals in favor or five or six small meals throughout the day. The more food you dispatch to your stomach the greater the odds of heartburn.
- Years ago I used to work long hours in the hospital and would eat a full dinner at 9 or 10 pm. I got woken up with heartburn a number of times before I wised up and stopped eating big meals late at night. If you have that habit, check out this article I wrote on the risks of late night eating.
- Don’t lie down after a big meal. That invites stomach acid to travel sideways into your esophagus. Elevate your head in bed with an extra pillow. Or go for a stroll after eating and try to stay upright for a few hours, allowing food to leave your stomach before you lie down.
- Cut down on fried and fatty foods. Both take up more digestive time in the stomach, and are linked to severe symptoms of heartburn. Much of the fat in the American diet comes from large servings of meat, particularly fatty cuts of poorer quality.
- Chocolate, alas, contains chemical compounds that weaken the LES. Sorry chocolate lovers, but it is a common cause of heartburn.
- Forgo after-dinner mints. Forget their reputation as digestive aids. They actually relax the LES, and often within a few minutes. Instead of mints or antacids, take one or two chewable tablets before meals of deglycyrrhizinated licorice (DGL), an extract of the licorice plant. It has been widely used as a remedy for heartburn as well as ulcers.
- Go soft on soft drinks, a major predictor of nocturnal heartburn. They cause a temporary weakening of the LES and increase the acidity of the stomach, as does caffeine and alcohol.
- Aspirin also relaxes the LES. I’ve seen many patients who developed heartburn even from taking low-dose aspirin.
Different people tend to have different heartburn triggers. For one person it may be chocolate and for the next person, onions or alcohol. Whenever you have a bout of heartburn, jot down what and how much you ate before. It won’t be long before your heartburn journal will give you the clues as to what foods or drinks to ease up on.
- Sinatra S, Punkre J, Bent R. The Healing Kitchen (Bottom Line Books, 2010).
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