Cutting out foods may not be the only answer to dealing with the discomfort of heartburn.
Food is one of the greatest joys of life, but for some people, after the pleasure comes terrible pain. Heartburn has many names including ‘indigestion’ and ‘acid reflux’. According to The Gut Foundation, seven in ten Australians will suffer from this uncomfortable sensation at some point in our lives.
Heartburn happens when the valve between the stomach and oesophagus opens more than it should, allowing powerful acid to rise from the stomach into the lower oesophagus. “Heartburn results in a burning sensation in the chest or throat, sometimes accompanied by a bitter or sour taste in the mouth, or other issues like a persistent cough and hoarse voice,” explains Melanie McGrice, accredited practising dietitian and Director of Nutrition Plus clinics in Melbourne.
What causes it?
Anything that puts a lot of pressure on the stomach can trigger an attack. For instance, eating a lot at once; lying down too soon after a meal; or exercising after eating.
Pregnancy is also a common trigger as the baby can put a large amount of pressure on the stomach. Sometimes Irritable Bowel Syndrome causes severe bloating which puts tension on the stomach, leading to heartburn.
McGrice also points out that a hectic lifestyle can play a major role. “The common scenario is people skip breakfast, drink lots of caffeine, eat something small on the run, then consume most of their day’s food in one sitting at dinner,” she explains.
A healthier approach is to eat three regular meals, or six smaller meals, to see if the lower volume of food helps reduce the reflux.
It’s also helpful to sit upright during and after meals, and avoid slouching in a reclining armchair.
When we’re in a hurry, it’s easy to quickly shovel in food, which can bring on indigestion.
“Eating slowly and mindfully with small mouthfuls, chewed well, can help reduce heartburn symptoms,” McGrice adds.
These foods and drinks are common culprits, so try our handy tips.
Tea and coffee may cause changes in stomach acid. Caffeine can also increase the pressure on the valve in your lower oesophagus, which leads to reflux.
Tip: Order weak coffees or make your own milder version at home. Reduce tea strength by using tea bags, or only steeping loose-leaf tea for a few minutes.
For some of us, alcohol acts as an irritant in the gut. Some people may also find they can tolerate alcohol for one day but not several days in a row.
Tip: Choose a lower alcohol beverage and drink it with a meal, not on an empty stomach. Avoid bubbly drinks which can bring on an attack.
Citrus fruits and tomatoes
Our stomach acid is much stronger than acid in foods like oranges, lemons and tomatoes. However, these foods could worsen reflux. Some people have an intolerance to salicylates, natural chemicals found in certain foods, which may trigger reflux.
Tip: Eat smaller serves of potentially irritating foods, and monitor how this affects your symptoms.
Fat can slow digestion which means if you eat a fatty meal and then eat again soon after, it can cause a build-up of food and pressure in your stomach.
Tip: Avoid fried meals, rich meat dishes and creamy sauces. Cook meals at home with minimal oil or fats.
Hot foods like chilli and peppers, along with aromatic garlic and onion, are gastric stimulants. In response, our bellies can produce more acid, leading to heartburn symptoms.
Tip: Eat milder curries, use less spices and swap garlic and onions for milder herbs like chives or shallots.
The comforting effect of peppermint may encourage greater relaxation of the valve at the top of the stomach, allowing acid to flow back into the oesophagus.
Tip: Choose a different herbal tea like calming chamomile.
Milk and yoghurt
Many people report that these foods soothe their painful symptoms of heartburn.
Some sufferers find bread, pasta and rice help settle heartburn. “This may be because they help soak up some of the stomach acid,” says Caroline Salisbury, accredited practising dietitian.
Unfortunately, both these food solutions aren’t healthy long-term fixes. If you constantly use food or drink to ease your symptoms, see your GP or gastroenterologist for advice.
When it burns all the time
When heartburn is persistent and occurs more than twice a week, the diagnosis is gastroesophageal reflux disease (GORD). According to the Gastroenterological Society of Australia, GORD can lead to more serious health problems, including oesophageal cancer.
“Minimising your intake of trigger foods is important,” says McGrice, “but resist the impulse to ban foods completely from your diet, as you risk not getting enough important nutrients.”
Medications can help to treat GORD. Proton pump inhibitors (PPIs) reduce the level of stomach acid. Although these drugs are considered to be very safe, they do have potential side effects, and can reduce your absorption of nutrients including calcium, iron, vitamin B12 and vitamin C. That doesn’t mean you should stop taking your medication, as untreated GORD can cause sleep loss, reduce appetite, and even lead to cancer.
You can reduce heartburn pain and the need for medication by making simple changes to your eating habits. “I encourage my patients to start with the fours Ps,” says Salisbury:
Plan: Cook ahead and spread out your nutritious meals and snacks evenly across the day.
Pace: Eat slowly and try to find a calm environment.
Portion: Avoid gorging on large, dense meals and snacks.
Position: Sit upright when eating, and leave 2–3 hours between your last meal and bed.
Did you know? Seven in 10 of us will suffer from heartburn at some point.