Ways to avoid "heartburn season"

Making merry often is synonymous with overindulging--whether from holiday feasts or rich desserts or alcoholic beverages. As a consequence, ringing in the holidays often turns into "heartburn season." Heartburn--generally caused by naturally occurring acids splashing back up from the stomach--usually is marked by a characteristic burning sensation that sufferers describe as rolling up into their chest. Fatty foods play a starring role in this process.

Heartburn most often is caused by the reflux or backwash of acid from the stomach up into the esophagus, which is the long tube that carries food from the throat to the stomach. A valve at the end of the esophagus is supposed to function as a one-way release, relaxing to allow food into the stomach and closing back up so food and acid in the stomach stay there while the food is digested. If there is a leaky valve, gastroesophageal reflux disease, or GERD, may result. The primary symptom is heartburn.

"As a general rule of thumb, anything that tastes really good is likely to give you heartburn, and the reason is the fat content," indicates Stuart Spechler, professor of internal medicine in digestive and liver diseases at the University of Texas Southwestern Medical Center, Dallas. "Fat does a lot of things that promote heartburn. It stops the stomach from emptying well, so now you have more material in the stomach that's ready to reflux. It also further weakens that leaky valve.

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"Most of the time, heartburn is a nuisance, not a tremendous threat to your health. I tell most of my patients that it's going to be a tradeoff--is the food going to taste good enough to suffer through the heartburn? If you know you're going to eat something that ordinarily gives you heartburn, there are medications that you can take before eating that food which might help."

For decades, the plop-plop-fizz-fizz approach of antacids taken after people already were experiencing heartburn was the only therapy available. Emphasis since has shifted to prevention. Those who are planning to indulge in foods likely to cause them heartburn can take a histamine receptor blocker (H2 blocker), which slows the production of stomach acid and generally is available over the counter. "Most people suffering from heartburn get it every now and then. Those are the people who really benefit from this on-demand therapy," Spechler notes. "If you're going to eat something you know is going to give you heartburn, you can take one of those pills a half-hour before your meal, and you may be able to prevent the heartburn."

The most powerful type of medicines, and the ones more suited for people who have ongoing heartburn, are called proton-pump inhibitors. "They're very powerful at stopping the stomach from making acid, but it takes a number of hours or even days for them to reach their full effect. So, if you want to eat a pizza in the next half-hour, it's not going to stop the acid that you're going to make in that time," Spechler explains.

Antacids can help if foods consumed generate heartburn, as they act like a sponge to soak up the excess stomach acid, but they do nothing to prevent the stomach from creating more. So, it may help to take some antacid tablets to soak up acid currently being produced and take an H2 receptor blocker to slow the stomach from producing further acid.

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COPYRIGHT 2008 Gale, Cengage Learning