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5 Tips for Preventing Heartburn

Heartburn is a common symptom of acid reflux, which is caused by stomach acid backing up into the esophagus. If you suffer from frequent heartburn, learn what you can do to prevent and treat the pain.

5 Tips for Preventing Heartburn

  1. Eat smaller, more frequent meals. Large meals put added pressure on the lower esophageal sphincter (LES), the valve between the stomach and esophagus that’s supposed to keep stomach acid from flowing back up. Eating smaller servings can reduce the amount of acid in your stomach and pressure on the LES, helping to prevent heartburn.
  2. Don’t lie down after eating. Waiting two or three hours to lie down after eating gives gravity a chance to pull the food and digestive juices from the stomach down into the intestines.
  3. Avoid known heartburn triggers. While everyone responds differently to specific foods, certain foods tend to be common heartburn triggers for a lot of people and are best avoided if you’re prone to reflux. These foods include: fatty meats, fried foods, citrus fruits and juices, chocolate, peppermint, red wine, tomato-based foods, coffee, sodas, peppers, garlic, and onions.
  4. Keep your clothes loose around your waist. Wearing tight belts or waistbands can squeeze your stomach, putting added pressure on the LES that can lead to reflux. Undergarments meant to slenderize can be especially restrictive for your digestive tract.
  5. Maintain a healthy weight. Extra pounds mean extra pressure on your abdomen. Statistics show that as many as 35% of overweight people suffer from heartburn.

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Heartburn Prevention Tips for Spicy Food Lovers

Millions of heartburn sufferers have been told to avoid spicy foods in order to find relief from their heartburn symptoms. But is giving up the foods you love the only answer? Check out these heartburn tips for spicy food lovers.

3 Heartburn Prevention Tips for Spicy Food Lovers

  1. Know your own heartburn triggers. Mint, alcohol, caffeinated coffee, and other foods are believed to cause the lower esophageal sphincter—the valve between the stomach and esophagus that is supposed to keep stomach acids at bay—to relax. This relaxation causes reflux. But researchers have had difficulty proving these theories during clinical trials. Doctors admit that what triggers heartburn in one person may cause no reaction in another, so the best way to prevent heartburn without unnecessarily avoiding “safe” foods is to get to know your own triggers. Keep a food journal for several weeks and document what you eat, how much you eat, and when heartburn symptoms occur.
  2. Eat smaller servings. If you find that your favorite foods do, in fact, trigger your heartburn, it’s probably best to avoid them all together. But if you can’t bear the idea of giving it up forever, try eating smaller amounts. Eating too much at one time puts added pressure on your stomach and LES, causing acid reflux and heartburn. Limiting your portion sizes might allow you to enjoy the taste of your favorite foods without paying the painful price.
  3. Chew gum. Chewing gum after and between meals stimulates the production of saliva, your body’s natural acid neutralizer. It also helps move food and acids down the esophagus and into the stomach. If you do chew gum, avoid minty flavors, as this may trigger heartburn symptoms for you.

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Acid Reflux Drugs Cause Rebound Symptoms

While proton pump inhibitors (PPIs) treat acid reflux symptoms very effectively, a new study suggests that patients who stop using them may experience rebound symptoms. Researchers at Copenhagen University studied 120 healthy adults who had no symptoms or history of acid reflux disease. The participants who took daily doses of the PPI Nexium for eight weeks reported almost 30% more acid-related symptoms than the participants who took placebos.

Christina Reimer, MD, the lead researcher, suggests that this acid rebound effect, known as “rebound acid hypersecretion,” is a result of a stomach acid-stimulating hormone called gastrin. In response to the PPI-related acid suppression, gastrin is overproduced, and once the PPI is stopped, the stomach works overtime to create acid.

The relevance of this study has been questioned by a manufacturer of Nexium and Prilosec. Blair Haines, a spokesman for AstraZeneca Pharmaceuticals, said, “This study was conducted in healthy volunteers, and the authors acknowledge that they can’t be sure that the conclusion can be carried over to patients who have started PPI therapy because of dyspeptic symptoms.”

The study does appear to consider that issue by admitting that the benefits of PPI therapy still appear to outweigh the risks for patients who have established acid reflux disease. Additionally, it’s unlikely that people who take the over-the-counter version of Prilosec for short periods of time will experience rebound acid hypersecretion.

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Cooking Tips for Heartburn-Friendly Meals

Frequent heartburn is a painful annoyance that most sufferers would love to be able to avoid. Before your doctor prescribes medication or more invasive treatment options, you may try making a few simple lifestyle changes to find relief from your heartburn. For many, this means taking a second look at what you eat and how you prepare your meals. Learn how to make great food that won’t leave you suffering from heartburn pain.

Cooking Tips for Heartburn Sufferers

1. Stay away from heartburn-inducing ingredients. While not everyone responds the same way to all foods, there are a few foods that are more likely to cause heartburn than others. Try leaving these foods off your plate and take note of how your stomach responds.

Top Heartburn Foods to Avoid:

  • citrus fruits
  • spicy foods
  • tomato-based foods
  • mint
  • chocolate
  • coffee
  • alcohol

2. Go lite! Fatty foods often take longer to digest, which increases the chances of you finishing your meal with heartburn. Experiment with low-fat ingredients and less fatty cooking techniques, like broiling instead of frying.

3. Practice portion control. Diet experts will tell you to watch how much you eat in order to keep tabs on your weight, but eating smaller portions can also help you avoid heartburn. Large meals sit longer in your stomach and cause your body to produce even more stomach acid, which is a known risk factor for acid reflux and heartburn. Use measuring cups to dole out portions on a smaller dinner plate.

4. Add water. Drinking water with your meals can help dilute stomach acid and reduce the risk of reflux. Stay away from carbonated water—the extra bubbles can make your heartburn worse. Stick with tap or filtered water during your meals to help wash down those painful stomach acids.

Frequent heartburn is a painful annoyance that most sufferers would love to be able to avoid. Before your doctor prescribes medication or more invasive treatment options, you may try making a few simple lifestyle changes to find relief from your heartburn. For many, this means taking a second look at what you eat and how you prepare your meals. Learn how to make great food that won’t leave you suffering from heartburn pain.

5. Stay away from heartburn-inducing ingredients. While not everyone responds the same way to all foods, there are a few foods that are more likely to cause heartburn than others. Try leaving these foods off your plate and take note of how your stomach responds.

Top Heartburn Foods to Avoid:

  • citrus fruits
  • spicy foods
  • tomato-based foods
  • mint
  • chocolate
  • coffee
  • alcohol

6. Go lite! Fatty foods often take longer to digest, which increases the chances of you finishing your meal with heartburn. Experiment with low-fat ingredients and less fatty cooking techniques, like broiling instead of frying.

7. Practice portion control. Diet experts will tell you to watch how much you eat in order to keep tabs on your weight, but eating smaller portions can also help you avoid heartburn. Large meals sit longer in your stomach and cause your body to produce even more stomach acid, which is a known risk factor for acid reflux and heartburn. Use measuring cups to dole out portions on a smaller dinner plate.

8. Add water. Drinking water with your meals can help dilute stomach acid and reduce the risk of reflux. Stay away from carbonated water—the extra bubbles can make your heartburn worse. Stick with tap or filtered water during your meals to help wash down those painful stomach acids.

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Effects of Uncontrolled Heartburn

Heartburn and acid reflux affect millions of people every year. Because it’s common, you may be inclined to believe that frequent heartburn is no big deal and something you should simply learn to endure. However, frequent heartburn that is left untreated can lead to more serious health complications.

What causes heartburn?

In most cases, the pain of heartburn is caused by stomach acid flowing back up into the esophagus. Frequent heartburn can be a symptom of GERD, or gastroesophageal reflux disease. GERD patients experience persistent heartburn and acid reflux because the valve that’s supposed to keep acid inside the stomach is malfunctioning in some way. While occasional reflux may be nothing more than an uncomfortable annoyance, uncontrolled and recurring heartburn can cause long-term problems.

What are the effects of uncontrolled heartburn?

  • Esophagitis: Repeated exposure to stomach acids can injure the lining of the esophagus and cause painful inflammation known as esophagitis. Esophagitis can also cause ulcers, painful, open sores on the lining of the esophagus, and bleeding.
  • Cancer: In some cases, long-term GERD can lead to a condition called Barrett’s esophagus (BE). This condition is characterized by new, abnormal cells forming to replace those damaged by constant exposure to acid. Over time, Barrett’s esophagus can lead to cancer. People who suffer from nighttime heartburn are especially prone to developing cancer as a result of their acid reflux.
  • Narrowing of the esophagus: If your esophagus is damaged from acid, it may develop a buildup of scar tissue that narrows the opening of the esophagus. This can cause problems with swallowing and the ingestion of food.
  • Respiratory problems: It’s believed that GERD causes respiratory problems because acid backs up into the airway and nasal passages. Frequent heartburn has been linked to an increased risk for asthma, chronic bronchitis, chronic cough, chronic sinusitis, emphysema, and recurrent pneumonia.
  • Dental problems: GERD patients have been shown to have more erosion of tooth enamel than people without GERD. Stomach acids that back up into the mouth can also cause bad breath.

If you have heartburn that occurs two or more times a week, contact your doctor. There are treatment options available to handle heartburn and GERD, and they can prevent you from experiencing any of these long term effects.

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Treating Heartburn and Acid Reflux

If you’re suffering from heartburn, your doctor will probably conduct a few routine tests to diagnose the source of your heartburn discomfort and rule out any underlying cardiac problems. After pinpointing the source of your problems are reflux related, there are several options your doctor may recommend for the diagnosis and treatment of your heartburn.

Diagnostic Tests for Evaluation of Heartburn

If you’re complaining of frequent heartburn you may be suffering from symptoms of another underlying health problem. Your doctor may run a series of diagnostic tests to evaluate if your chest pain and heartburn is caused by GERD, an acid-reflux disease.

The Proton Pump Inhibitor Test

If you have non-cardiac chest pain, your doctor may have you take a proton pump inhibitor, a medication that reduces the production of acid in the stomach. After a trial period, your doctor will assess whether or not PPI treatment alleviated your symptoms. The benefit of this type of diagnostic test is that it is simple, safe, and generally cost-effective. The proton pump inhibitor test is also less invasive than other diagnostic testing methods.

pH Monitoring

If your doctor is concerned about abnormal esophageal acid exposure, or if your symptoms do not respond to PPI treatment, you may undergo 24-hour pH monitoring. This diagnostic test is also commonly used to determine if a patient is a good candidate for antireflux surgery.

To perform esophageal pH monitoring, a thin plastic tube is inserted into one nostril, down the back of the throat, and into the esophagus as you swallow. An acid sensor on the tip of the tube is positioned in the esophagus, just above the lower esophageal sphincter. The sensor records each reflux of acid that occurs over the next 24 hours and reports to a recorder that you carry with you.

This diagnostic test helps create a correlation between acid reflux and the symptoms you’re experiencing.

Esophageal Manometry

During an esophageal manometry, a tube is inserted into your nose and down your throat. You’re then asked to lay on your left side and swallow small amounts of water. A sensor on the tube measures how much pressure your body is exerting on the tube. The test takes 20 to 30 minutes to complete.

An esophageal manometry can help your doctor determine how well your lower esophageal sphincter, the valve that should keep acid from backflowing into your esophagus, is functioning. It can also test whether your esophagus is moving food into your stomach properly. An esophageal manometry may also be done before pH monitoring to determine where the sensor should be placed.

Possible Treatment Options For Serious Heartburn

Lifestyle Changes

If you have mild symptoms of heartburn or acid reflux, your doctor may suggest making simple lifestyle changes before further intervention. Some of these modifications may include elevating the head of your bed to reduce nighttime reflux, staying away from acid-inducing foods, avoiding late-night meals or snacks, and quitting smoking.

Medication

Your doctor may prescribe a medication designed to decrease your body’s production of acid. The most common and typically effective medications used in these instances are proton pump inhibitors, or PPIs. Other medications that are less commonly used to treat heartburn include histamine receptor-2 antagonists (HR2As) and smooth muscle relaxants.

Surgery

Some patients will not respond to PPI therapy, or are responsive but do not wish to be on long-term medication. In these instances, antireflux surgery may be suggested as a treatment option. Currently, the two most commonly performed antireflux surgeries are Nissen fundoplication and Toupet partial fundoplication.
Talk to your doctor about which treatment for heartburn and chest pain is right for you. You’ll want to consider the severity of your symptoms, the underlying cause of your pain, and overall effects on your lifestyle.

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Laryngopharyngeal Reflux

GERD, or gastroesophageal reflux disease, is characterized by stomach acid that flows back into the esophagus. The symptoms of GERD include frequent heartburn that occurs more than twice a week. In some cases, stomach contents will actually flow past the esophagus up to the larynx or pharynx, which are located at the back of the throat. This is referred to as laryngopharyngeal reflux or pharingotracheal reflux.

Laryngopharyngeal reflux (LPR) and GERD are two related, yet different, diseases. They each have different risk factors, symptoms, and treatments. People who suffer from one type of reflux disease are not necessarily diagnosed with other types of reflux diseases.

LPR Symptoms vs. GERD Symptoms

The most common symptoms of gastroesphageal reflux disease include:

  • Frequent heartburn
  • Pressure or nausea in the stomach
  • Regurgitation
  • Reflux symptoms when laying down

People who suffer from laryngopharyngeal reflux or pharingotracheal reflux do not usually complain of frequent heartburn. Instead, their symptoms are more likely to include:

  • Hoarseness
  • Globus sensation (feeling a lump in your throat)
  • Throat-clearing
  • Sensation of postnasal drip
  • Difficulty swallowing
  • Chronic cough
  • Laryngospasm (vocal chord spasm that makes it difficult to speak or breathe)
  • Reflux symptoms when sitting up

GERD can cause damage to the esophageal lining. LPR, on the other hand, involves damage to the laryngeal mucosa. Because the laryngeal mucosa is more susceptible to injury from acid reflux, it usually requires a longer treatment time for the symptoms of laryngopharyngeal reflux and pharingotracheal reflux to subside.

Diagnosing Pharingotracheal or Laryngopharyngeal Reflux

Pharingotracheal reflux (or, Laryngopharyngeal reflux) involves stomach acid backflowing past the esophagus to the larynx or pharynx, which lies at the top of the the larynx before the split between the esophagus and trachea. This type of reflux is usually characterized by hoarseness, sore throat, or upper respiratory problems rather than frequent heartburn.

Often times, LPR can be diagnosed by a simple examination in a doctor’s office. A mirror and light is used to view the throat and vocal box. In people suffering from LPR, the tissue in the throat may appear to be red, irritated, or swollen.

Further diagnostic testing may include barium esophagography, radionucleotide scanning, the Bernstein acid perfusion test, esophagoscopy with biopsy, impedance testing, and pH probe to determine the extent of damage caused by pharingotracheal or laryngopharyngeal reflux.

Treating Pharingotracheal or Laryngopharyngeal Reflux

While it often takes as little as two weeks of treatment to reduce symptoms of GERD, it may take several months of treatment for LPR symptoms to resolve. Treatment for LPR may include:

  • Histamine blockers: Medicines such as Pepcid, Tagamet, or Zantac that reduce acid production
  • Proton pump inhibitors: Medicines such as Prilosec, Nexium, or Prevacid that prevent stomach acid from forming
  • Lifestyle changes: Eating smaller meals, avoiding late-night snacks, and quitting smoking
  • Dietary changes: Avoiding alcohol, caffeine, carbonated beverages, citrus fruits and juices, fatty foods, and spicy foods

If antireflux therapy does not reduce the symptoms of LPR, further testing may be needed to rule out another underlying laryngeal disorder.

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Hiatal Hernia

A hiatial hernia is a rare anatomical abnormality that is usually seen in an adults and is thought to have developed over the course of several years.

What is a hiatial hernia?

A hiatial hernia is a condition in which part of the stomach protrudes through the diaphragm and up into the chest. Normally, the esophagus passes through a small hole in the diaphragm and is connected to the upper stomach just below the diaphragm. In people with a hiatial hernia, the opening of the diaphragm is larger than normal and part of the stomach pushes up past it so that the connection between the esophagus and stomach is now located above the diaphragm.

What causes hiatial hernias?

There are three common physical causes that can contribute to a hiatial hernia.

Large esophageal hiatus: The opening in the diaphragm that the esophagus normally passes through is called the esophageal hiatus. If this opening is larger than normal, the stomach can have room to push up past the diaphragm.

Permanent shortening of the esophagus: If the esophagus is shortened, possibly due to damage from acid reflux, it can pull the stomach up farther into the chest than it should be, past the esophageal hiatus.

Loose attachment of the esophagus to the diaphragm: If the connection between the esophagus and the diaphragm isn’t secure, that can also cause the stomach to slip up into the upper chest.

Although most hiatial hernias do not cause noticeable symptoms, in some cases they can lead to GERD, a condition associated with frequent heartburn and acid reflux. In these cases, repairing the hiatial hernia with surgery may help reduce the symptoms of GERD.

Types of Hiatal Hernia

A hiatal hernia is a condition in which part of the stomach protrudes through the diaphragm and up into the chest. There are two different types of hiatal hernias.

Sliding Hiatal Hernias
The most common type of hiatal hernia is referred to as a sliding hiatal hernia. This occurs when the junction of the esophagus and stomach, or gastro-esophageal junction, and part of the stomach protrude into the chest. While the gastro-esophageal junction can permanently rest in the chest, it usually only juts into the chest during a swallow. When you swallow, the esophagus contracts and shortens and pulls the stomach up. A sliding hiatal hernia will fall back down beneath the diaphragm when the swallow is finished.

Para-Esophageal Hiatal Hernias
The less common type of hiatal hernia is called a para-esophageal hiatal hernia. In these cases, the junction between the esophagus and stomach stays below the diaphragm, but part of the stomach itself actually bulges up into the chest around or beside the esophagus. A large para-esophageal hiatal hernia may cause food to stick in the esophagus after it is swallowed or cause ulcers in the herniated part of the stomach.

Most hiatal hernias cause no symptoms; however, in some cases, hiatal hernias can cause frequent heartburn or acid reflux associated with GERD. Hiatal hernias can only be diagnosed by upper gastrointestinal x-ray or endoscopy and are usually discovered incidentally while trying to address other health concerns.

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What is Proton Pump Medication for Heart Burn?

Heart burn is a miserable and often chronic condition. When you have chronic heart burn, your stomach acid creeps up from your stomach into your esophagus through a loose or strained valve. It can leave you with a bitter tasting sting in your throat that often feels like your actual chest is burning.

There are many over the counter medications used to fight and treat heart burn. Some of these medications are known as proton pump inhibitors, and they are the latest defense in an age-old battle.
Proton pump inhibitors work by attaching to some of the pumps that rest in the lining of your stomach. Normally, these pumps are responsible for releasing the stomach acid that helps you break down foods and get them ready for absorption and digestion.

With proton pump inhibitors attached, however, the pumps are unable to produce acid. The inhibitors only affect a few pumps within the stomach lining, thereby decreasing the overall amount of acid your pumps are able to produce, but not stopping it all together. This leads to less stomach acid and less heart burn without compromising your body’s ability to digest food and absorb vital nutrients.

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