Ask a Dietitian

As seen on BCTV July 24/01

STOMACH ACID DISORDERS: HEARTBURN

Heartburn is common among Canadians: over one-half of us experience this form of indigestion from time-to-time. However, for some, the battle against heartburn is fought daily. Though occasional heartburn is not dangerous, the esophagus does not have a protective mucous lining. Thus, frequent indigestion may lead to throat ulcers.

Many factors predispose individuals to heartburn. These include obesity, pregnancy and hiatal hernias. Each of these conditions places upward pressure on the lower esophageal sphincter that separates the stomach and esophagus, often forcing stomach acid up the esophagus. Several factors can cause heartburn by weakening the lower esophageal sphincter pressure. When this sphincter relaxes, an opening is created that allows the acidic contents of the stomach to enter the esophagus. To avoid this discomfort, here are some tips to help you control heartburn:

• Eat small, spaced out meals: Eating too much at one time may cause reflux, a condition where your stomach allows food to flow back into the esophagus. It is therefore wise to eat smaller meals more often.
• Eat a high-protein and low fat diet. Protein will help keep the LES sphincter closed and prevent reflux. Fat stimulates the relaxing of the sphincter and hence it’s opening.
• Reduce caffeine: Caffeine can promote acid production, increasing your risk of heartburn. Coffee (including decaffeinated), tea, cola, and chocolate are sources of caffeine.
• Reduce acidic foods: Acidic foods such as tomato-based products, vinegars and citrus juice may promote heartburn by acidifying the stomach contents. Consume these foods in small amounts.
• Limit fatty foods: Fat takes a long time to digest, and therefore slows down the rate at which food empties from the stomach. This in turn causes you to stay full longer and increases the risk of heartburn. Choose fatty meats, cheeses and cream or oil-based products less often, as well as foods that are cooked in a lot of fat. Instead, fill your plate with fruits, vegetables, whole grains, beans and legumes and lean meat and low-fat dairy products.
• Do not eat before bedtime: Reclining after you have just eaten is a problem: gravity simply isn’t working on your side! To solve the problem of reflux associated with lying down, wait two hours after a meal before you recline (including before bedtime). Also, stand or sit up straight after meals instead of slouching, and refrain from bending over.
• Limit alcohol and peppermint: Alcohol and peppermint weaken the lower esophageal sphincter and promote reflux.
• Quit smoking: If you did not already have enough reasons to quit smoking, here is another. The nicotine in cigarettes weakens the sphincter that keeps the stomach contents from entering the esophagus allowing acid to move upwards.There is little evidence that spicy food, other than pepper, can cause heartburn. However, because each person is different, refrain from eating any foods that appear to aggravate the condition.Watch for the Eating for Energy segment every Tuesday on BCTV’s Noon News Hour!