Heartburn Help
Learn what to eat—and what to avoid—to manage acid reflux

By Liz Zack

During a recent dinner out, Carol Baines, a 27-year-old New Yorker, decided the fish and chips looked too good to pass up. “And it was really delicious going down,” she says. “But literally half an hour later I was saying, ‘oh no.’” Baines, who suffers from chronic heartburn, knows an unwise meal choice can lead to hours of discomfort. Also called acid reflux, sour stomach, or GERD (gastroesophageal reflux disease), heartburn is common: Approximately 60 million Americans suffer an episode at least once a month, and 25 million Americans experience it daily.

But avoiding heartburn is within your power. By knowing which foods calm or disturb digestion, identifying your personal food triggers, checking with a doctor if you have persistent heartburn, and tailoring your diet, you can steer clear of unnecessary distress.

What causes heartburn?
When you eat, food travels down the esophagus until it reaches the lower esophageal sphincter (LES), a muscle that opens to permit food to enter the stomach and closes to protect the esophagus from stomach acids. “Heartburn occurs when stomach contents get past the LES and squirt back up into the esophagus,” says Michael S. Richardson, MD, internal medicine specialist and author of Health Basics (Next Decade Inc., 2003). “The stomach is built to handle acid, but the esophagus is not.”

Antiheartburn habits
Lose weight. Excess body weight puts undue stress on the stomach.
Stay upright for two to three hours after eating, to give the stomach time to empty.
Loosen your belt.
Added pressure from tight clothing may contribute to acid reflux.
Check your meds. Certain medicines, including those for blood pressure and arthritis, can exacerbate heartburn.

—L.Z.

Certain foods and drinks, including chocolate, peppermint, onions, garlic, and alcohol, weaken or relax the LES. Others may irritate or even dissolve the esophagus’ protective mucous lining, including acidic foods (think tomatoes and oranges), caffeinated beverages, hot peppers, and alcohol. If you suffer frequent heartburn, your digestive system might not tolerate even small amounts of these common culprits.
 

Soothe the suffering
Although health care practitioners often advise mild foods for heartburn sufferers—“the blander the better,” says Lori Yenesel, RD, of Overlook Hospital in Summit, New Jersey—that doesn’t mean you’re destined to a lifetime of saltines and weak tea. Many delicious foods and easy techniques allay symptoms, and others can help prevent reflux before it starts. Take these tips to the table.

For more information

National Heartburn Alliance
Download free self-care brochures, browse FAQs, and find gut-friendly recipes at this comprehensive site.
www.heartburnalliance.org; 877.471.2081 Watch fats and spices. Because fatty foods weaken the LES and take longer to digest, reducing fat intake greatly decreases reflux risk. Bake, broil, or boil foods instead of frying, and shy away from fatty ingredients. At restaurants, question waiters about food preparation. If high-fat foods and spices cause you digestive distress, “ask the chef not to add butter or oil when preparing your dish,” says Yenesel, and go light on super-hot seasonings.

Dilute. Plain H2O and watery drinks, such as decaffeinated or herbal teas, ease heartburn by diluting hydrochloric acid in the stomach. Chewing gum also helps by increasing saliva production, a natural buffer. In fact, a recent study found that antacid gum worked better than tablets for relieving heartburn discomfort (Alimentary Pharmacology and Therapeutics, 2002, vol. 16, no. 12).

Common heartburn triggers
Alcohol
Caffeine
Carbonated beverages Chocolate
Citrus
Fatty foods
Garlic
Onions
Peppermint
Spicy foods
Tomato products

Source: Eating for Acid Reflux by Jill Sklar and Annabel Cohen (Marlowe & Company, 2003). Pass the mustard. Yes, you heard right: Some heartburn sufferers swear by mustard to relieve pain. In Natural Stomach Care (Avery Penguin Putnam, 2003), authors Anil Minocha, MD, and David Carroll recommend eating a half-teaspoon of mustard when heartburn strikes. “Use of mustard seeds is an age-old home-remedy digestive aid for reflux symptoms,” says Minocha, because the seeds stimulate bile secretion and digestive enzymes that help neutralize stomach acid. Other experts credit turmeric, the anti-inflammatory herb responsible for commercial mustard’s yellow color, for the condiment’s soothing effect.

Enjoy friendly foods. Certain edibles contain compounds that help reduce reflux risk. For example, low-acid papaya boasts papain, an enzyme that aids digestion. Other low-acid foods include ripe bananas, peaches, figs, cherries, and cantaloupe. Salmon, avocado, and yogurt all contain pantothenic acid, a helpful B vitamin. And try tea steeped with fresh ginger, chamomile, or lemon balm, herbal all-stars for easing digestive distress.

Think small. Big meals slow digestion and increase heartburn risk. “It’s pure mechanics,” says Richardson. “If the stomach is fuller, there’s more pressure, [so] there’s a greater chance that some acid will leak the wrong way.”

Know your triggers
Because every person is unique, it’s important to track your body’s reactions to particular foods. “I recommend that people keep a food diary for several days,” says Yenesel. “Write down everything you eat and circle the things that cause pain or discomfort.” Be sure to include food quantities; you may find that 8 ounces of orange juice causes no symptoms, but 10 ounces induces pain. Carol Baines knows that paying attention pays off, and she keeps her pain in check by eating responsively. “I’ve gone through periods where it’s apples, rice, bananas, and toast for a couple days,” she says, but on other days she can be more adventurous—even sneaking a few bites of fried fish off her fiancé’s plate every now and then.