Heart burn is a common problem. The symptoms occur when the stomach acid backs up into the food pipe (esophagus). Esophagus is a tube that transports food from your mouth to your stomach. The stomach lining is much different than the lining of the esophagus. The stomach lining produces digestive juices including hydrochloric acid to help with digestion of food; hence it is tolerant of the acid inside the stomach. In contrast, the food pipe lining gets irritated from acid contact. To prevent food from backing up into it, the food pipe is separated from the stomach by the lower esophageal sphincter (LES). However when you eat heavy meals, fatty foods, caffeinated or spicy foods, stomach acid backs up into the esophagus along with food. As a result you may feel the acid taste in your mouth, or heart burn sensation in your epigastrum, behind the sternum (in your esophagus), or may just feel chest pain symptoms that are so severe that you feel like you are having a heart attack. These symptoms may last for hours or may be relieved with an ant-acid, H2 blockers like zantac, drinking cold milk, and/ or sitting up or walking around to help digestion.
The heart burn usually gets worse when you lay down. Upon lying down, the acid can easily leak back into the food pipe which is now leveled with the stomach. The acid may flow back from the stomach all the way into the food pipe, voice box, lungs, and mouth. Hence you may get irritation of the esophagus, vocal cords, and mouth. Thus you may experience symptoms such as chest pain, epigastric pain, cough, asthma, hoarseness in your voice, or just a bad taste in your mouth. If left untreated, you may get ulceration and bleeding in the food pipe. Overtime you may develop narrowing of the food pipe and strictures may form in your food pipe. If the heart burn persists for more than five to seven days, you must see your doctor to avoid serious complications.
If you have heart burn, the following steps should help for at home treatment:
1) Avoid eating heavy meals, acidic and spicy foods. Heavy meals take longer to digest, and stimulate higher acid production.
2) Avoid eating up to 3 hours before going to bed. For example, if you go to bed at 10 pm, then your last meal for the day should not be any later than 7 pm.
3) Eat small meals- 6 small meals spread throughout the day. Small amounts get easily digested and help move the food faster along the food pipe. Also frequent meals will help avoid the urge to binge on food, and keep sugar levels stable throughout the day. This step also helps those who are trying to lose fat.
4) Avoid caffeinated foods and drinks.
5) Avoid chocolate and mint
6) Avoid carbonated drinks
7) Avoid sitting or lying down immediately after eating.
8) Cold milk will help neutralize the acid
9) Multiple medicines can also cause stomach irritation, so take medicines on full stomach or with milk and yogurt, unless specifically advised otherwise.
10) Yoga posture can help relieve acid reflux and speed up digestion. Instead of sitting on a chair or sofa after eating, sit down on your heels on the carpet or floor with your legs folded, and your hands on your knees. This excercise is great for digestion and acid relief.
9) Raise the head of the bed on 2 bricks on each side. Then sleep on the slanted bed. The slope will keep the acid from backing into the food pipe. Using more pillows to raise your head is usually not effective.
10) Get yourself checked for sleep apnea, especially if you snore. Sleep apnea can alter the pressure within the food tube, and cause LES to open to release acid into the food pipe. You may need help with sleep apnea.
11) If you have a large waist, start working on reducing the belly weight. Belly weight tends to put pressure on the stomach and pushes the stomach contents back up into the food pipe.
12) Avoid wearing tight clothes, especially around the waist line. Night clothes should be comfortable and relaxing.
If these steps do not help and heart burn continues to persist for over a week, please see your doctor or nurse practitioner for further help or medications.