 then it will be important to describe the symptoms you are experiencing. The “My History” function of MyGiHealth asks more about heartburn, reflux, and regurgitation, and can help you describe translate your symptoms into “doctor talk” should you plan to see a healthcare provider.
What causes it?
The most common reason people get heartburn is because acid from the stomach rises into the esophagus. There are several reasons why this can happen:
- Weak esophagus muscles. A weak esophagus may not move food or liquids through the esophagus into the stomach. This can happen when the esophagus muscles don’t squeeze normally, don’t squeeze strongly enough, or the muscles don't work together in a coordinated way.
- Weak LES. The muscular ring at the bottom of the esophagus, called the lower esophageal sphincter (LES), may be weak or open too often. This allows food to rise up, or reflux, from the stomach to the esophagus.
- Weak stomach muscles. Stomach muscles are too weak to grind up food and move it into the small intestine. This allows stomach contents to move back up into the esophagus.
- Hiatal hernia. This is when the top of the stomach bulges, or “herniates”, above the diaphragm. This weakens the barrier that keeps food from rising out of the stomach into the esophagus.
Obesity. Obesity is more likely to cause heartburn because:
The LES opens more often
Extra weight may cause a hiatal hernia
Extra belly fat puts pressure on the stomach, causing acid reflux
How do I manage it?
Food can cause heartburn in three ways:
- Foods high in acid can irritate the esophagus.
- Certain foods, like fatty or greasy foods, can cause the lower esophageal sphincter (LES) to relax more often than normal.
- Eating too much food stretches the stomach and causes the LES to relax more often than normal.
One of the most important ways to prevent heartburn is to avoid overeating. But there may also be specific foods that cause heartburn more than others, like:
- Rich, fatty, or fried foods
- Fizzy drinks
- Tomato sauce
- Citrus fruits and juices, like lemons, oranges, or grapefruit
- Ketchup and mustard
- Alcoholic drinks, like red wine
- Spicy foods, like salsa, peppers, or hot sauce
Everyone is different. It’s important to listen to your body and learn which foods cause your heartburn.
Some ways to help control heartburn are:
- Don't overeat at mealtimes.
- After eating, wait 2 to 3 hours before lying down.
- Raise the head of the bed 3 to 6 inches with a brick or boards. (Or raise your head AND upper body 3 to 6 inches using pillows when lying down.)
- Maintain a healthy weight. (Losing weight will help overweight patients.)
- Avoid doing exercises that put extra pressure on your belly (like sit ups) if they make symptoms worse.
- Don’t smoke. Smoking can weaken the LES muscle and increase your risk of esophageal cancer.
PROS AND CONS OF THE DIFFERENT TYPES OF ACID REDUCERS
Antacids (Acid Neutralizer):
- How well it works: weak effect
- How long it works: weak effect
- How quickly it works: strong effect
- When to take: Mild, infrequent heartburn
H2 Blocker (Acid Reducer):
- How well it works: weak effect
- How long it works: medium effect
- How quickly it works: medium effect
- When to take: Mild - moderate heartburn
Proton Pump Inhibitor (PPI):
- How well it works: strong effect
- How long it works: strong effect
- How quickly it works: weak effect
- When to take: Moderate - severe, frequent heartburn
Antacids (for mild, infrequent heartburn)
Antacids neutralize acid in the stomach. This helps to ease heartburn and acid indigestion.
There are different types of antacids, which include:
H2 Blockers (for mild to moderate heartburn)
- H2 blockers reduce the amount of acid made in the stomach. They are often called “acid reducers."
- They are used to treat heartburn caused by gastroesophageal reflux disease (GERD) and ulcers.
- Lower strengths are available over the counter. Higher strengths have to be prescribed by a doctor.
Proton Pump Inhibitors (for moderate to severe heartburn)
Proton Pump Inhibitors (PPIs) stop the release of acid in the