What are the symptoms and treatment of heartburn?

You lay down on the couch to relax after a delicious meal, but instead start to feel a burning sensation or pain near the middle of your chest. Sound familiar? Here, we discuss the symptoms and treatment of heartburn.

What causes heartburn?

Heartburn symptoms usually begin when a muscular valve called the lower oesophageal sphincter (LES) has a problem keeping food acid in your stomach where you need it.

The LES acts like a one-way automatic door at the point where your oesophagus meets your stomach, which is down below the rib cage and slightly to the left of centre. 

When it’s working properly, the LES opens up to let your food pass through and down into the stomach, or to expel unwanted gases (burping/belching) up and out of the stomach. Then it closes again to help stop anything unwanted (like your food acid) coming back up.

But if the LES opens too often, or doesn’t close tightly enough, your stomach acid can seep up into the oesophagus. This is what causes the burning and sometimes painful sensation we know as heartburn.

So why isn’t your LES closing tightly like it’s supposed to? This may be caused or aggravated by overeating, when there’s simply too much food in your stomach and it’s forced back up. 

Another possible cause is too much pressure on your stomach, which can happen because of obesity, constipation or pregnancy. If you’re pregnant, the hormone progesterone can relax your LES and may lead to heartburn. Smoking also relaxes the LES and increases stomach acid.

How can you get rid of heartburn?

There are several natural treatments you can try which may help and some well-known foods that you should avoid or limit.

• Eat a healthy diet. Try to avoid eating for at least two or three hours before you go to bed so your stomach has a chance to empty before you lie down.
• Also pay attention to how you eat. Eat slowly, taking smaller bites.
• If you’re overweight, following a diet and exercise program to shed some of those excess kilos may help. Excess abdominal fat can press against the stomach, forcing acids up into the oesophagus.
• Keeping a food diary is a great way to pinpoint which foods are your triggers (see foods to avoid below), then try to avoid them. Write down what you’ve eaten and when your heartburn symptoms occur. This can help you identify and remove problem foods from your diet.
• Quit smoking. Smoking can reduce the effectiveness of the muscle that keeps acids in the stomach. For this, and so many other health reasons, there’s never been a better time to quit.
• Loosen your belt. Clothes that are too tight can put extra pressure on the abdomen.
• Tilt your bed. Place something sturdy under the pillow end of your bed to raise it by about 15cm/6 inches. Don’t bother raising your pillows, though – it’s not effective for heartburn.
• Relax. Stress and lack of sleep can increase how much acid your stomach makes.
• You may have heard that drinking a glass of milk can relieve heartburn. Milk can temporarily buffer stomach acid, but go easy, because nutrients in milk, particularly fat, may stimulate the stomach to produce more acid. 
• It may sound unlikely, but chewing gum does stimulate the production of saliva, which works as an acid buffer. Chewing gum makes you swallow more often, which pushes those unwanted acids out of your oesophagus.

Foods to avoid to reduce heartburn

Avoiding certain foods can help reduce heartburn as some foods relax the LES allowing your stomach acid to come back up into your oesophagus. 

These include:

• Fried or greasy foods
• High-fat meats
• Creamy sauces
• Whole-milk dairy products
• Chocolate
• Peppermint
• Alcohol
• Caffeinated drinks like soft drinks, coffee, tea, and cocoa

Other foods are unhelpful because they can stimulate acid production. These include:

• Caffeinated drinks
• Carbonated drinks
• Alcohol
• Spicy foods
• Citrus fruit and juices like oranges and grapefruit
• Garlic and onions
• Tomato-based products

Whatever treatment combination you choose, please consult a doctor if symptoms persist.

Heartburn in pregnancy

Nearly half of all women will experience heartburn at some stage during their pregnancy. It does vary from pregnancy to pregnancy but it can sometimes appear as early as the second month of the first trimester and continue throughout the entire pregnancy. 

As the baby grows, it presses on the woman’s stomach which leaves less room for food. So, eating smaller food portions can help set it off.

There are various ways to help alleviate the pain of heartburn during pregnancy. Ginger and peppermint herbal tea can sometimes soothe the burning feeling. Always make sure you consult your doctor to work out what is right for your pregnancy.

If reflux and regurgitation are making it difficult for you to sleep, then it can help to raise your pillow at night.

If symptoms persist, speak to a doctor.

This article was written by Fergus Taylor, a freelance communications and engagement writer with a corporate and government background encompassing health, infrastructure, media, advertising, environment, emergency services and justice.