December 03, 2022
Ever experienced symptoms of heartburn? Most everyone has had a bout of this at one time or another, experienced as upper abdominal and chest discomfort or burning. But heartburn, technically known as gastroesophageal reflux, can also cause less obvious symptoms such as a chronic sore throat, a cough, and even a bad taste in your mouth.
To understand why acid reflux happens, it’s helpful to review a bit of anatomy. When you swallow your food, it passes down your esophagus to your stomach. At the entrance to the stomach there is a ring of muscle (the lower esophageal sphincter or LES) which normally closes as soon as food goes through it to prevent the food and stomach acid in the stomach from backflowing into your esophagus.
If something goes wrong with the LES so that it doesn’t fully close or it opens up a bit too often, stomach acid can flow up into your esophagus causing the symptoms of heartburn. Stomach acid is strong and it breaks foods down so the body can absorb nutrients, but the tissue north of the esophageal sphincter is not designed to withstand stomach acid. So when the acid moves up through the sphincter, it starts to burn the tender esophageal tissue.
If this happens twice a week or more, you may have what is known as GERD or gastroesophageal reflux disease. If this happens repeatedly, the lining of your esophagus can become damaged. If the damage becomes severe enough this can lead to bleeding, chronic inflammation, and in a small percentage of people to esophageal cancer, so it’s important not to ignore persistent symptoms.
Gastric reflux is an incredibly common disorder and many of these people use prescription medication as well as over the counter remedies in an effort to get relief. But many cases of reflux respond well to simple lifestyle changes that may make medication unnecessary. Let’s get a look at some of the things you can put into practice to get your reflux symptoms under control.
Don’t eat before bed - When you are standing or even sitting, gravity works with you to keep food and stomach acids in your stomach, where they belong. If you eat less than three hours prior to bed, the stomach contents are better able to flux back up into the espohagus when you recline. So finish your last meal at least three hours prior to bedtime and also avoid naps after eating.
Sleep on an incline - Ideally, you should elevate your head six to nine inches higher than your feet by either using tall bed risers on the legs at the head of your bed or using a foam wedge under your mattress. Trying to do this with pillows will not work as it’s not uniform enough.
Don’t stuff yourself - Keeping the contents of your stomach to a lower volume will help to decrease pressure and keep food where it belongs. Avoid large meals in favor of several small meals.
Watch out for trigger foods -No you don’t have to go on a “bland” diet or stick to tea and toast, as that advice has been proven ineffective. But some people still find they have certain food that can trigger symptoms, such as tomatoes, spicy foods, coffee, tea, chocolate, fatty foods, mint, and alcohol. You may want to consider eliminating these foods then add them in one by one to help identify any food triggers you may have. Also avoid carbonated beverages as a rule, as they tend to make you burp and send acid into the esophagus.
Watch your weight - Excess weight puts pressure on your stomach, forcing food and acid upward and worsening reflux.
Check your meds - Some medications can cause acid reflux to worsen, including certain anti-depressants and anti-inflammatories. Check with your doctor. Also smoking can relax the LES and worsen your symptoms, so if you smoke, perhaps it’s time to quit.