Anatomy of a heartburn

It begins with a munch of that hot, spicy beans porridge. You swallow, and it travels through your gullet to your stomach. A ring of muscles opens like a valve to let the food in. Acids go to the stomach to break down the beans. The ring is supposed to close again to prevent stomach […]

It begins with a munch of that hot, spicy beans porridge. You swallow, and it travels through your gullet to your stomach. A ring of muscles opens like a valve to let the food in. Acids go to the stomach to break down the beans. The ring is supposed to close again to prevent stomach acid from sliding into the throat, but it doesn’t close properly.

The acid seeps through into your gullet. It is called acid reflux. It triggers a painful, burning feeling in the middle of the chest.

Heartburns usually strike after meals and can last several hours. It can worsen after bending over or lying down. You may also have a sour-tasting fluid in the back of your throat, have difficult swallowing or feel there is food stuck in your chest.

Anyone can develop heartburn, but certain lifestyle factors affect how well the sphincter works, as well as the amount of acid produced by the stomach. People who are overweight, eat large meals, wear tight-fitting clothes, or smoke tend to be more vulnerable.

Heartburns may not be an immediate danger to your health, but complications can occur when the acid reflux is severe, frequent and persistent.

Many people with gastro-oesophageal reflux disease (GERD) usually progress from having severe heartburn two or more times a week. Without treatment, chronic GERD can cause inflammation, ulcers and scarring. It can also lead to changes in the cells lining the oesophagus, raising the risk of oesophageal cancer.

Waking with a sore throat, cough, or a bitter taste in your mouth? It could be nighttime acid reflux. In addition to disturbing sleep, nighttime reflux may raise the risk of esophageal damage. That’s because lying down leaves stomach acid in the esophagus longer. And as we sleep, we swallow less acid-neutralizing saliva than when awake.

You may be able to manage mild heartburn with a few changes to your daily routine. Start by eating smaller meals. Finish dinner at least three to four hours before bedtime and avoid late-night snacks. (Having food in your stomach when you lie down can worsen acid reflux symptoms such as heartburn.)

Some foods are known to contribute to heartburn by bringing additional acid into the stomach or by relaxing the lower oesophageal sphincter. Stay away from food that may give you problems. Your symptoms may improve if you avoid tomatoes, onions, garlic, chocolate, peppermint, fatty foods, and citrus fruits, including oranges and grapefruit. If you find spicy foods are a trigger, try milder versions rather than giving up your favourite foods altogether.

Certain beverages can also bring on heartburn. These include coffee, tea, sodas, alcohol, tomato juice, and orange juice. However, unless these are causing you acid reflux symptoms, you don’t have to avoid them.

If you have nighttime heartburn, try placing blocks under the legs of your bed to raise the head about 6 inches, or sleep with your upper body on a wedge pillow. This strategy uses gravity to keep stomach acids where they belong. (Avoid raising your head with piles of pillows. This bends your body in a way that can aggravate heartburn.) For some, reflux also happens less frequently when lying on your left side rather than your right.

Another way to ease heartburn is to take pressure off the abdomen. Lose excess weight and wear loose-fitting clothes and belts.