As I approach 40, it's become obvious to me that my youthful "iron" digestion isn't what it once was. Having only ever suffered from indigestion and heartburn during pregnancy, it's hard to adjust to the pain and discomfort heartburn now regularly brings, especially at night.
I wanted to become more informed about heartburn, indigestion and acid reflux, and having taken both my GP's and some more alternative views I've discovered that there are options to treat the causes of heartburn holistically, instead of relying on over-the counter short term antacids to relieve the symptoms. Instead, try to find a permanent relief - by eating a healthier diet, exercising and generally looking after ourselves we can at least start to address holistically the causes of heartburn.
However as always it's important to remember that if in doubt, or if your heartburn is occurring frequently, consult your GP, as the symptoms of other more serious health issues could be mistaken for heartburn. A burning sensation in the chest can also be a sign of a heart attack. If you're not sure, consult your GP or go to hospital immediately, especially if you experience shortness of breath, light-headedness, dizziness, cold sweat, nausea, or pain in your shoulders or neck.
What is Heartburn?
The medical term for heartburn is Pyrosis, which is defined as an uncomfortable feeling of burning and warmth occurring in waves rising up from the breastbone toward the neck and into the throat. Heartburn is usually due to a wider digestive disorder called acid reflux or gastroesophageal reflux disease (GERD), the regurgitation of stomach acid back up into the oesophagus.
When we eat, food normally enters the stomach and is prevented from backing up by a band of muscle at the end of the oesophagus called the lower oesophageal sphincter. Heartburn occurs when this muscle doesn't properly close and the acidic contents of the stomach are able to back up into the oesophagus. Pregnancy and obesity can also increase abdominal pressure and increase your risk of experiencing acid reflux as well. Other digestive disorders such as a peptic ulcer or insufficient digestive enzymes in the stomach can also cause stomach acid to build up and back up into your oesophagus.
Known Causes of Heartburn
There are many causes of heartburn and acid reflux, the most common of which are listed below. It may be helpful to add up how many of these apply to you, and decide where you can make changes in your lifestyle to alleviate instances of heartburn.
Spicy , Fried and Fatty foods (including full-fat dairy products)
These foods all tend to slow down digestion, keeping the food in your stomach longer.
Coffee, tea, and other caffeinated and carbonated drinks
Caffeine can relax the lower oesophageal sphincter (LES), allowing stomach contents to reflux into the oesophagus.
Obesity
There is a widely acknowledged link between being overweight and suffering from heartburn. Extra weight around the abdomen area can apply pressure on the stomach and thereby cause the normal acid contents of the stomach to reflux.
Chocolate
Chocolate contains concentrations of theobromine (a compound that occurs naturally in many plants such as cocoa, tea and coffee plants), which relaxes the oesophageal sphincter muscle, letting stomach acid squirt up into the oesophagus. This can result in increases pressure in the stomach, which in turn puts more pressure on a weakened LES, allowing reflux of stomach contents.
Other "Trigger" Foods
Tomatoes and tomato-based products
Citrus fruits, especially fruit juices
Peppermint and spearmint products
Dry fruits and nuts especially peanuts, walnuts and almonds
These foods are all known to relax the lower oesophageal sphincter.
Alcohol and Smoking
Alcohol also relaxes the lower oesophageal sphincter, as well as increasing the production of stomach acid. The chemicals in cigarette smoke further weaken the LES as they pass from the lungs into the blood. If you smoke and drink, and have regular heartburn episodes, look long and hard at your habits if you want to make long-term improvements in this area.
Large meals
A full stomach can put extra pressure on the lower oesophageal sphincter (LES), which will increase the chance that some of this food will reflux into the oesophagus.
Eating prior to bedtime and late-night snacks
Lying down with a full stomach can cause stomach contents to press harder against the LES, increasing the chances of refluxed food.
Eating in a rush or in a stressful environment
When we're eating on the go or in a stressful environment it is possible to bolt food down, chew insufficiently, and overdose on "bad" food and drink such as alcohol, caffeine, sugars and fatty foods. During stressful times, routines are disrupted and people may not follow their normal eating routines - it's also a time we're more likely to "comfort eat" and break with healthy eating patterns. By addressing issues that cause stress in our lives, we can also reduce the likelihood of stress-related heartburn.
Wearing tight fitting clothes
Clothing that fits tightly around the abdomen (belts, tight underwear, pyjamas etc) constricts the stomach, forcing food up against the LES, and cause food to reflux into the oesophagus.
Heartburn Prevention
Many heartburn sufferers experience symptoms at night. The following suggestions may help with nighttime symptoms. Eat your main meal of the day at lunch instead of at dinnertime, and avoid late dinners and snacking - have your last snack no later than two hours before bedtime. This way your stomach won't still be working on that big meal when you go to bed.
Eat at least two to three hours before lying down. If you take naps, try sleeping in a chair. Lying down with a full stomach can cause stomach contents to press harder against the LES, increasing the chances of refluxed food.
Avoid foods that are known to lead to heartburn, especially as your evening meal or later. If you aren't sure what foods trigger your heartburn symptoms, try keeping a heartburn record for a week.
Sleep with your head and shoulder on an incline. Lying down flat presses the stomach's contents against the LES. With the head higher than the stomach, gravity helps reduce this pressure. You can elevate your head in a couple of ways. You can also use a wedge-shaped or "V" shaped pillow to elevate your head, or simply sleep with an extra pillow.
Sleep on your left side.
Make sure your bed clothes are loose-fitting.
Avoid lying down right after eating. Give your body a couple of hours to digest the food you've just eaten.
Give up smoking and reduce your alcohol intake
Take an antacid tablet as soon as you feel heartburn symptoms.
Begin a diet and exercise programme if you're overweight. More importantly, take a good look at what you are eating, and avoid where possible the foods listed above, or any others that you think may be contributing to your heartburn.
Reduce your stress levels. Sing, dance, meditate, practice deep breathing or do yoga to help your body relax. This will help to reduce the pressure on your stomach.
Carminatives are drugs or natural agents whose main action is to soothe the gut wall and gas production in the digestive tract. By doing so they can remove the pressure of flatulence and digestive pain by soothing stomach muscles and increasing secretions of digestive juices. Chamomile, fennel, clover, ginger, peppermint, garlic and sage all have a carminative action.
If you feel as if the foods you are consuming are not being digested properly, talk to your GP about the possibility of taking digestive enzymes before each meal to help break down foods in the stomach and improve digestion. Food enzymes come in many forms. There are broad spectrum food enzymes that can help to digest proteins, carbohydrates and fats. There are also specialized enzymes that help digest specific types of foods such as fats, proteins and milk.
Alleviating Heartburn Symptoms
If you experience heartburn or acid reflux at night, first elevate your head or the head of your bed. Remain upright until the pain subsides, either propped up in bed or in a chair. Take an antacid tablet as soon as possible.
Some additional remedies to consider are listed below:
Have a cold glass of milk
Many sources state that apple cider vinegar is helpful for heartburn. Try taking 2 tablespoons of apple cider vinegar and 2 tablespoons of raw honey in a glass of water before a heavy or late meal or when heartburn strikes
Aloe Vera juice, Chamomile, Ginger and Peppermint herbal tea are all supposed to be helpful for preventing heartburn - you can buy herbal teabag selection packs at your local health food shop or larger supermarket chains and try them out before investing in a single flavour.
A teaspoon of Baking soda dissolved in a glass of water is another reported reliever, however check with your GP if you are trying to regulate your sodium intake.
Slowly sucking on a boiled sweet is reported to help some sufferers
The good news is that you don't have to suffer repeatedly from heartburn and acid reflux; most people can obtain excellent relief with dedicated commitment to healthy eating and daily habits.