November 29, 2019
Heartburn is a condition that plagues many of us after a culinary indulgence, which means Thanksgiving marks the start of some serious holiday heartburn.
But heartburn is actually a symptom of acid reflux, or GER (gastroesophageal reflux), which affects about 60 million Americans during the holiday season, according to the American College of Gastroenterology.
Normally, when you swallow, the band of muscle around the bottom of your esophagus -- the lower esophageal sphincter -- relaxes, which lets food and liquid flow down into your stomach. Then the muscle tightens again.
However, acid reflux occurs when stomach acid backs up into the esophagus and irritates the tissue, often because the sphincter relaxes abnormally or weakens. The esophagus lies just behind the heart, which is where heartburn pain is felt. The acid backup, and therefore the pain, is often worse in the evening, after eating, or when bending over or lying down. Symptoms also include (via Medicinenet):
Here are some ways to avoid holiday heartburn this Thanksgiving and Christmas.
According to the Mayo Clinic, the following foods are likely to trigger a bout of heartburn.
Avoiding these foods means avoiding that awful, burning pain behind your breastbone in the first place.
Peppermint, alcohol and chocolate can relax the sphincter muscle between your esophagus and your stomach, while coffee, tomato products, and large or fatty meals can affect the level of your stomach acid.
Acid reflux attacks can be triggered by how much food is in your stomach. The more food in your stomach, the more likely your stomach will overproduce the acids it needs to break that food down. This increases the chance that those stomach acids will back up over the food and into your esophagus.
That means you should take care not to stuff yourself at your holiday parties and dinners. Instead, eat slowly and give your body time to get used to the amount of food incoming. By being mindful of portion sizes, you will give your stomach time to digest smaller amounts bit by bit rather than struggling to absorb one or two giant meals.
Lying down can make heartburn pain worse, as it makes digestion harder on your stomach and increases the chance of heartburn occurring. If you wait about two to three hours before your after-dinner nap, this allows more time for food to pass through your stomach, reducing the odds of experiencing holiday heartburn pain.
Instead of lying down, at least sit up with your head higher than your stomach. Alternatively, consider going for a walk and letting that activity aid your digestive process.
It doesn’t make any sense to wear tight clothing to a holiday that centers food and eating, but for GER or GERD sufferers, there’s an additional reason to go with flowy apparel. Tight-fitting clothes or waist-cinching belts can squeeze your stomach, which may lead to food or stomach acid surging back up into the esophagus.
“When lifestyle changes are not helping, there are medications available to prevent and help treat heartburn,” says Stella Badalova, PharmD, Director of Healthcare Relations and Clinical Development at Medly Pharmacy. “The most common medications are antacids, which help make the stomach less acidic. Examples of some antacids include Maalox, Mylanta, and Tums. The two other types of medications work by decreasing the amount of acid the stomach produces. These are the H2-blockers (Pepcid, Zantac) and the Proton Pump Inhibitors (Prilosec, Prevacid).”
When deciding on a medication, Stella says, “First, you need to determine the type of relief you need and second, how often you experience heartburn. An antacid is the perfect choice for heartburn that occurs occasionally and you need quick relief. To help control heartburn that occurs more frequently, an H2-blocker would be recommended. For times that require longer-lasting quick relief, try combination products such as Tums Dual Action or Pepcid Complete. For severe and more frequent heartburn, a PPI such as Prilosec or Nexium would be recommended as they last up to 24 hours. However, patients should keep mind that PPIs are high-priced and have a delayed onset of action.”
Of course, when starting any new medication, including over-the-counter (OTC) products, you should speak to a pharmacist to make sure the new drug will not interact negatively with your current therapies. “Patients with severe heartburn, if symptoms worsen or no improvement is made after 14 days, should seek medical care immediately to avoid further complications. Patients using OTC products should not use OTC products for more than 14 days at a time unless directed by a physician,” Stella says.
Suffering from acid reflux doesn’t have to spell doom on your Thanksgiving holiday. If you follow the tips above, you may find that your risk of experiencing heartburn lessens. And if you are on medication for gastroesophageal reflux disease, consider switching your medications to Medly Pharmacy to make sure you have them on hand in time for the holiday.