UPMC Physician: Understanding and Dealing With Heartburn
By: Dr. Puneet Basi, M.D.
Ever wake up from a deep sleep to a burning sensation in your throat? Maybe chronic coughing? We’ve all enjoyed a night out to a nice dinner, maybe pizza, a drink or two, and chocolate for dessert. Then a few hours later, while in bed, maybe regret that decision to have that last piece of pepperoni pizza. Heartburn and digestive issues hit us all at one time or another in our lives, it’s important to know how to prevent it and how to deal with it.
What is heartburn?
Despite its name, heartburn does not affect your heart. Instead, it happens when acid from your stomach backs up into your esophagus (the tube that connects your throat and stomach). It causes symptoms like:
- Pain or burning in your throat or chest
- A feeling like food is backing up in your throat
- Coughing or feeling the need to clear your throat
- Burping or belching
- Excessive mouthwatering
There’s a muscle at the bottom of your esophagus that opens to let food pass into your stomach when you eat. This muscle should stay closed afterward, but sometimes it relaxes or doesn’t close tightly. This allows stomach acid to come back up (reflux) into your esophagus and is more prominent when you lie down. It’s not uncommon to have a mild or occasional case of heartburn after you eat something acidic or when you eat too much or too fast. But some people get heartburn more frequently. You might be at higher risk if you:
- Are overweight
- Are pregnant
- Drink alcohol
- Take certain medicines for anxiety, pain relief, asthma or blood pressure
- Family history of these symptoms or Barrett’s esophagus
All our bodies are different and react differently to different foods. We first need to understand what food triggers digestion issues. It’s not to say you still can’t enjoy your favorite foods, but you have to be smart and prepare. Some of the food and drinks to be careful of are:
- Tomato-based foods like pizza, ketchup, or spaghetti sauce
- Spicy foods
- Fried or fatty foods
- Acidic foods like vinegar-based salad dressings or citrus juices
- Carbonated soft drinks
- Coffee (even decaf)
Preventing heartburn completely may not always be possible, so it’s important to know how to live with it, when it, hopefully, rarely occurs.
Dealing with heartburn
While uncomfortable, intermittent heartburn can be managed by minor lifestyle changes. Limiting instances of heartburn can be as simple as finding a common root cause in your day-to-day behaviors. Some common lifestyle changes that limit intermittent heartburn include:
- Avoid trigger foods and beverages that are listed above
- Lose weight
- Give up smoking or tobacco
- Wait at least two to three hours after eating before lying down to sleep
- Sleep with your head raised about six inches
- Avoid exercise right after eating
- Avoid tight-fitting clothing or belts around the waist
- Reduce stress
Over-the-counter (OTC) remedies coupled with lifestyle changes can be effective as well. For all medications, remember to pay close attention to the directions and warnings on the box. Antacids (like calcium carbonate) can neutralize stomach acid. H2 blockers (like famotidine) and proton pump inhibitors (usually a medication with Pantoprazole) can be purchased over the counter and used for more frequent or recurring heartburn. These medications reduce, in varying degrees, the amount of stomach acid your body produces to manage your symptoms and help you feel more comfortable. If your heartburn is chronic or if you have any alarming symptoms like weight loss, blood in stool, loss of appetite, difficulty swallowing, anemia, family history of Barrett’s esophagus, or older than 75, reach out to your gastroenterologist.
Puneet Basi, M.D., is a gastroenterologist and sees patients at UPMC Williamsport, 700 High Street, Williamsport. To schedule an appointment with Dr. Basi, call 570-321-3454. For more information, visit UPMC.com/DigestiveNCPA.