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If you suffer from heartburn ( acid reflux symptom ) and feel like you’d do anything to get from relief, this article could be the most important one you’ve ever read. If you thought your heartburn was just something you have to live with, there’s good news: you can control your heart burn — and even relieve it altogether.

There is much you can do to prevent heartburn. It is essential that you take action, as chronic reflux can actually damage your oesophagus. This part of your body is not protected against the corrosive action of stomach acids. If you get heartburn frequently – many people suffer from it daily- it is essential that you follow the tips below with regards to changing your lifestyle and diet.

• Fast food is fat food. Fatty foods such as hamburgers and pies can give you heartburn. Plan your daily meals, so that you are not starving while stuck between two appointments and fast food is the only option. Cut down generally on your fat intake.
• Snuff it out. Stop smoking – do whatever it takes, whether it’s hypnosis, Smokenders, nicotine patches or therapy. Apart from worsening the symptoms of heartburn, smoking is bad for your health in general.
• Scrap the late night snack. If you eat a packet of chips just before you go to bed, it has had no time at all to digest before you get into a horizontal position. You know what happens next. Allow at least three hours between your last meal and bedtime, giving your body time to digest the meal before you lie down.
• Grill rather than fry. Throw away your frying pan! Rather grill your foods, as it severely reduces the fat content of your meals.
• Get fresh. Fresh fruit and vegetables are rich in fibre and healthy in general. It is also easy to take these to work with you. Get into a habit of keeping fresh fruit at home and munch on these when you feel the need to snack. (Tomatoes and onions can increase the acid levels in your stomach, so go slow on these).
• Jeans too tight? Tight-fitting clothes around the abdomen make the job of your stomach difficult. The digestion process needs space and if your clothes fit too tightly, reflux may occur.
• Don’t hit the bottle. Too much alcohol can cause heartburn very easily. Two units a day are recommended for men and one for women. (A unit is one beer, one glass of wine, or one tot of spirits). It is not a good idea for those who suffer from heartburn to drink nothing all week and then drink seven beers on a Saturday night.
• Don’t spice up your life. Avoid spicy food as well as large quantities of salt and vinegar. Be on the lookout in restaurants and learn to ask about spice and salt content already added to preprepared foods.
• Caffeine crisis. Caffeine is bad news to all those suffering from heartburn. Learn to drink less tea and coffee and opt for soda drinks that do not contain caffeine. Rooibos Tea also does not contain caffeine and makes a pleasant alternative.
• Take time out. Constant stress can affect your digestive process and cause higher levels of stomach acid to be produced, even when there is no food in your stomach. Learn to relax, do some yoga classes and take some time out for yourself.
• Get moving. Exercise is good for your whole system and many people have found that their heartburn decreases once they switch to a healthier diet and they get some regular exercise. You do not have to do an Olympic training programme in order to get exercise – half an hour of brisk walking a day could make the difference.
• Don’t gobble up. Eat your food slowly. The faster you eat, the harder your stomach has to work and the more likely you are to suffer from heartburn. Take breaks in between bites. Empty you mouth completely and wait a moment or two before you start on the next bite.
• Don’t become a pillpopper. While there are many over-the-counter remedies that do work for heartburn, don’t lose sight of the fact that heartburn is your body’s way of telling you you should change your lifestyle. Rather than living on antacids, get to work on changing your diet and lifestyle, and make the heartburn disappear.

Although most people suffer from reflux of acid stomach contents (also known as heartburn) at some time or another, particularly when overindulging in rich foods and too much alcohol, some individuals are constantly plagued by acid from the stomach pushing up into the oesophagus.
This is caused by a defect in a valve or sphincter at the bottom end of the oesophagus that normally closes to prevent acid from the stomach pushing up into the oesophagus. If such a valve defect exists, the acid contents of the stomach will come into contact with the delicate lining of the oesophagus, causing damage. In some cases, bile acids from the gall bladder may also enter the oesophagus (which is an alkaline part of the digestive tract), and cause corrosion of the sensitive tissues.

Beat heartburn with the right foods

Let’s take a close look at gastro-oesophageal reflux disease (GORD) and at the way in which diet may be able to alleviate the pain and discomfort associated with this condition.

A physiological defect

Although most people suffer from reflux of acid stomach contents (also known as heartburn) at some time or another, particularly when overindulging in rich foods and too much alcohol, some individuals are constantly plagued by acid from the stomach pushing up into the oesophagus.

This is caused by a defect in a valve or sphincter at the bottom end of the oesophagus that normally closes to prevent acid from the stomach pushing up into the oesophagus. If such a valve defect exists, the acid contents of the stomach will come into contact with the delicate lining of the oesophagus, causing damage.

In some cases, bile acids from the gall bladder may also enter the oesophagus (which is an alkaline part of the digestive tract), and cause corrosion of the sensitive tissues.

Symptoms of GORD

According to Isselbacher and coworkers (1980), heartburn is the most typical symptom of GORD, which can manifest as severe pain in the upper and other parts of the abdomen.

Episodes of heartburn tend to occur after meals, especially if the meal has been rich or too large. Body movements such as bending over, lying down or lifting heavy objects, that cause strain, may make the symptoms worse.

Some patients may experience reflux during sleep, which is potentially dangerous as “regurgitated” material may be breathed into the lungs.

Approximately 20% of patients with GORD may have such severe and constant inflammation of the sensitive tissues of the oesophagus that this can lead to cancerous changes and bleeding. Swallowing can be extremely painful and patients may stop eating, which may lead to malnutrition.

Treatment of GORD

If you suffer from persistent, recurrent and severe heartburn, you should have a medical examination to find out if you are suffering from GORD.

The doctor will prescribe the necessary medication(s), of which antacids are first on the list. Liquid antacids line the stomach and also protect the inside of the oesophagus from contact with abrasive acid material such as stomach contents or bile acids.

More severe, chronic GORD, which can lead to permanent damage of the oesophagus, may be treated with medications called H2-antagonists and antacids. If medical and dietary treatments do not improve the condition, surgery may be indicated.

Patients are often also advised to raise the top or head end of their bed while sleeping to prevent reflux during the night.

Dietary treatment in GORD

Patients with GORD should not eat large, heavy meals and are advised to have small, light meals at regular intervals.

Try splitting up your three standard daily meals into five smaller ones, for example:

Breakfast: Cereal with yoghurt and milky Rooibos tea

Mid-morning snack: Sandwich with cottage cheese or a boiled egg and milky Rooibos tea

Lunch: 30g portion of lean meat or fish or egg with fruit and cooked vegetables

Mid-afternoon snack: 2 biscuits or rusks with milky Rooibos tea

Supper: 50g lean meat or fish with rice and cooked vegetables Canned fruit with custard or yoghurt

Do not eat anything in the 3-4 hours before going to bed.

Patients with GORD must experiment to find out which foods they must avoid. This is usually an individual reaction – one patient can eat brown or wholewheat bread without suffering any ill effects, while the next patient can only eat white bread.

You may find that avoiding spicy foods and condiments, very acid foods, gassy cold drinks, excessive coffee and tea, and all alcohol, will improve your condition a great deal. Foods that cause build-up of gas that distends the stomach and forces acid up into the oesophagus may also cause distress.

Common gas-producing foods are:

raw onions, garlic, shallots, leeks

the entire cabbage family – cabbage, broccoli, Brussels sprouts, cauliflower, Chinese cabbage and red cabbage

legumes (dry beans, peas, lentils, soya products)

As some foods cause so much pain and discomfort, you may have to eliminate them from your diet. This, however, can cause deficiencies if you do not substitute other foods that also contain the missing nutrient(s). The dietician will assist you with the correct choices.

GORD and overweight

A number of recent studies indicate that people who are overweight or obese may be more susceptible to GORD.

One of the latest editions of the Arbor Clinical Updates (2006), reports on two studies that investigated the link between body weight and GORD. In an American study of more than 10000 female nurses, it was found that women who were overweight or obese were more likely to suffer from GORD and had more severe symptoms.

Another report indicates that overweight and obese patients not only suffered more frequently and severely from GORD, but that they were exposed to a higher risk of cancer of the oesophagus.

The best step for any patient with GORD, who is overweight or obese, is to try to lose weight. This will improve symptoms and outcomes. If you consult a clinical dietician, she or he will also help you to start losing weight.

Treatment
If you experience only occasional, mild heartburn, you may get relief from an over-the-counter (OTC) medication and self-care measures. OTC remedies include:

Antacids. Antacids, such as Maalox, Mylanta, Gelusil, Rolaids and Tums, neutralize stomach acid and can provide quick relief. But antacids alone won’t heal an inflamed esophagus damaged by stomach acid. Overuse of some antacids can cause side effects such as diarrhea or constipation.H-2-receptor blockers. Over-the-counter H-2-receptor blockers, such as cimetidine (Tagamet HB), famotidine (Pepcid AC), nizatidine (Axid AR) or ranitidine (Zantac 75), are available at half the strength of their prescription versions. Instead of neutralizing the acid, these medications reduce the production of acid. They don’t act as quickly as antacids, but they provide longer relief. Take these medications before a meal that you think may cause heartburn because it takes them about 30 minutes to work. They’re also effective in reducing reflux at night if taken at bedtime. Some H-2-receptor blockers can cause infrequent side effects, including dizziness, diarrhea, headache, kidney problems and temporary breast enlargement in men. In rare instances they can also react dangerously with other medications.
Proton pump inhibitors. These medications block acid production and allow time for damaged esophageal tissue to heal. Omeprazole (Prilosec) was previously available only by prescription, but now is available in an over-the-counter form for the short-term treatment of heartburn.

If you have frequent and persistent heartburn, you may have GERD, leading to an inflamed esophagus. GERD usually requires prescription-strength medication or medical treatment and sometimes surgery.
Complementary and alternative medicine
Several home remedies exist for treating heartburn, but they provide only temporary relief. They include vinegar, drinking baking soda (sodium bicarbonate) added to water or drinking other fluids such as baking soda mixed with cream of tartar and water.
Although these liquids create temporary relief by neutralizing, washing away or buffering acids, eventually they aggravate the situation by adding gas and fluid to your stomach, increasing pressure and causing more acid reflux. Further, adding more sodium to your diet may increase your blood pressure and add stress to your heart, and excessive bicarbonate ingestion can alter the acid-base balance in your body.

Many heartburn sufferers swear by vinegar, especially apple cider vinegar as a remedy for heartburn. But vinegar is acidic – so how can one get relief by using vinegar for heartburn?

Too Little Acid

The lower esophageal sphincter (LES) forms the entrance to the stomach. Above it is the esophagus which serves only to transport food from the mouth to the LES. Once past the sphincter, acid begins breaking down the food. The muscles of the LES serve to open and close the entry to the acidic region. When food is swallowed, the LES opens. When no food is present in the esophagus, the LES stays closed.

The closed LES causes a pressure difference between the esophagus and stomach with higher pressure in the esophagus. If the muscles relax too much, the pressure equalizes and acid can enter the esophagus much more easily. A change in position, for instance, can cause a reflux of acid with the resulting heartburn. The pain from acid can make taking acidic vinegar for heartburn seem silly.

One of the things that trigger the LES to close tightly is acid. When acid is detected, the muscles pull tight to stay closed. If your stomach does not create enough acid or if you have eaten food that is very alkaline or just too low in acid, the muscles may relax. If that is the cause of your pain, the answer can be to drink a bit of vinegar for heartburn. A couple of tablespoons in a glass of water are enough.

Of course, drinking water alone can also help keep stomach acid where it belongs. Try some plain water first – you may not need vinegar for heartburn. Until you are sure that it works for you, you might want to take care in introducing acid to help cure an acid problem. Once you are sure it works, however, you can feel good about a daily dose of vinegar for heartburn if that’s what you want.