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Most people experience discomfort and pain near the heart after eating some food. ‘Heartburn’ doesn’t have to do anything with the heart. Studies suggest that more than 15 million people in developed countries experience heartburn daily.
Heartburn, unlike the name suggests, is a medical condition that causes a burning sensation in the esophagus, not the heart. The esophagus, commonly known as the food pipe, runs beside the heart, connecting the mouth with the stomach and transporting food down to where it can be digested.
The Lower Esophageal Sphincter (LES), present at the lower end of the esophagus, acts like a valve and mainly blocks or closes and releases the opening to the stomach after the food passes through it.
Under normal conditions, this valve closes after letting the food into the stomach and the stomach acid acts on the food to initiate the digestive process. Sometimes, certain foods may cause the LES to relax, causing the stomach acid to move upward. This is termed as Acid Reflux and results in heartburn symptoms.
1. Things to Know About Heartburn
1.1 What Does Heartburn Feel Like?
Heartburn gives a painful burning sensation right in the middle of the chest, near the sternum, where the LES meets the stomach.
This pain occurs when stomach acid reacts with the sensitive layers of the LES and gradually radiates toward the neck, throat, and face, causing severe discomfort. It usually happens after eating food or having late-night dinners.
1.2 Other Symptoms of Heartburn
Sometimes, heartburn can be accompanied by a lump sensation in the throat, acid or food regurgitation (sour taste of gastric contents in the mouth) and epigastric fullness that could result in belching, commonly known as burping.
1.3 What Causes Heartburn?
Acid reflux disease and GERD are the primary causes of heartburn. Furthermore, certain eating habits such as gobbling up, irregular eating, eating large portions of meals, frequent eating between meals even when not hungry (binge eating), and eating directly before sleep.
1.4 Factors Contributing to Heartburn
Being pregnant, Overweight/ obese, age, unhealthy lifestyle, and diet
Sometimes, intense workouts, especially those that focus on the abdomen region, could result in heartburn.
Lying down or bending over can increase the pain and make the heartburn worse.
Studies have pointed out prolonged stress and vital exhaustion as also the reasons for nonacid-related heartburn.
2. What is Gastroesophageal Reflux Disease (GERD)?
GERD is a chronic condition that arises due to recurrent painful instances of Heartburn and Regurgitation/ Acid Reflux. It is a lifestyle-oriented disease that is more common in developed countries, than in developing and under-developed nations, where almost 20% of the population is affected.
Although GERD is not life-threatening, without medical intervention, it may affect the overall quality of life in affected individuals and result in other esophagus-related complications like esophagitis, Barrett esophagus, and esophageal adenocarcinoma.
2.1 What are the Symptoms of GERD?
Heartburn, acid regurgitation, nausea, and noncardiac chest pain are the most common symptoms used to identify the disease, even without a clinical diagnosis. However, there are less common symptoms that need doctor’s intervention such as weight loss due to poor appetite, dysphagia (difficulty swallowing), and chronic cough.
In some individuals, unexplained cases of tooth erosion are also observed due to excessive gastric acid regurgitation over a while in both children and adults.
This process, along with inadequate saliva production, which acts as a protective layer for the dental pellicle, results in tooth erosion as the gastric acids displace saliva.
3. What is the Difference Between Heartburn, Acid Reflux, and GERD?
Understanding the difference in these three terms could help in the proper treatment of the specific condition and avoid unnecessary panic.
The three terms Heartburn, Acid Reflux, and GERD are different but closely related. Acid reflux is a disorder that causes stomach contents such as acids, digestive enzymes, juices, and/or food to backflow from the stomach to the esophagus.
Heartburn is just a symptom. Normal individuals can have reflux and still not feel the symptoms of heartburn. While occasional heartburn isn’t a problem, frequent incidents and failure to respond to non-prescribed medication need to be treated to avoid discomfort and function normally.
GERD is a severe form of acid reflux. Persistent refluxes over a while can lead to GERD. Heartburn is also a symptom of GERD. If not treated, it may lead to many gastroenteric long-term complications, even cancer.
On a positive note, all of these conditions can be rectified through simple lifestyle changes and diet.
4. What Foods to Avoid With GERD Symptoms and Acid Reflux
Both Acid Reflux and GERD can be managed through proper diet modifications. Hence, it is worth investing some time in understanding what not to include in the diet that could lead to heartburn symptoms more frequently. Here are some foods that could trigger chronic heartburn as per Harvard Health.
Acidic foods—These are generally not advised to be consumed on an empty stomach. They may include food with high natural acid content, such as citrus fruits, pineapple, and certain vegetables, like tomato and vinegar. Acidic foods could act as fuel to the fire, making heartburn worse.
Processed foods containing preservatives and acidity regulators.
Examples- Ketchups, jams, and sauces. (it is always good to check for the ingredients)
Spices– chili powder, pepper, and spicy foods. Some irritant alkaloids in these foods, such as capsaicin, can stimulate mechanoreceptors in the esophagus that could cause inflammatory lesions on the esophageal lining by stimulating the nerve endings.
High-fat foods– Various studies have shown the correlation between consuming high-fat foods and increased consumption of saturated fats and cholesterol to aggravate GERD symptoms.
This is because fatty foods reduce LES pressure, increase the rate of intermittent LES relaxation, and postpone gastric emptying, all of which would increase esophagus exposure to stomach acid in GERD.
Adding to this, consumption of fatty foods can indirectly contribute to GERD by increasing the weight of an individual leading to obesity and overweight, both of which are directly the causes of GERD. Examples- Milk cream, cheese, butter, meats, fried chips, etc.
Alcohol is neither an acid nor a base. Yet, studies suggest the negative influence of excessive and frequent alcohol consumption on the mucosa of the esophagus, and in intensifying the secretion of digestive juices in the stomach.
High-calorie diet– GERD signs were observed less frequently in those consuming a low-calorie diet, as per studies.
Examples- Pizza and other processed foods
Onions and garlic– Raw onion has more fermented fibers that could increase acid reflux.
Tea and Coffee consumption could significantly reduce LES pressure and increase heartburn symptoms, especially when consumed on an empty stomach.
Peppermint and Spearmint decrease the LES pressure.
Carbonated beverages increase stomach acidity and relax the LES. Some beverages also contain caffeine, which is a potent trigger for heartburn.
Chocolates contain caffeine and a compound called Theobromine. Both of which could trigger GERD symptoms.
Risk factors- age, pregnancy and genetics.
Along with all these, the nutritional composition of the diet, physical characteristics of the food (solid/liquid), portion size of each meal, and lack of proper sleep also contribute to acid reflux symptoms.
5. Foods That Help Prevent Acid Reflux
5.1 Alkaline Foods
Foods with a pH range greater than 7 are generally considered alkaline or basic. Alkaline pH tends to neutralize the acidity in the stomach, helping to relieve heartburn.
Examples- Bananas, Nuts, and legumes.
5.2 Water-Rich Foods
The role of watery foods is to dilute the stomach acid. A weak stomach acid cannot trigger reflux symptoms.
Examples- Melons, cucumber, celery.
5.3 High-Fiber Foods
Fibrous foods- Vegetables, specifically green vegetables like spinach, broccoli, whole grains like oats, millets, brown rice (unpolished rice)
5.4 Low-Fat Alternatives
Examples include skimmed milk, low-fat yogurt, lean meat, or plant-based meat.
5.5 Non-Citrus Fruits
Examples- Bananas, apples, and avocados.
5.6 Healthy Fats
Examples- Nuts, sunflower seeds, pumpkin seeds, and flaxseeds.
5.7 Healthy Beverages
Examples- Herbal tea, and plant-based milk.
6. Clinical Diagnosis of GERD and Acid Reflux
Diagnosis begins with a simple pH test like Ambulatory Reflux monitoring and Transnasal catheter pH testing to check for acid in the esophagus followed by endoscopy where a small tube with a camera and light is passed through the mouth and the digestive tract to check for signs of acid reflux or heartburn.
7. Treatment for GERD and Acid Reflux
Conventional treatment products can be classified as either acid neutralizers or acid suppressors/ blockers. Antacids and anti-refluxants are the most preferred and common Over-the-counter (OTC) drugs available for treating Acid reflux and managing symptoms.
Medical prescription of drugs such as Histamine H2 receptor blockers or Proton-Pump Inhibitors (PPIs). The five available PPIs are Omeprazole, Pantoprazole, Rabeprazole, Esomeprazole, and Lansoprazole. PPIs have been the best in reducing symptoms in the case of GERD mainly due to its safety and efficiency. They help in reducing the production of stomach acids.
Endoscopic therapy involving the application of radiofrequency also reduces symptoms by decreasing reflux. In rare cases, Anti-reflux surgery is performed.
8. Home Remedies to Treat Heartburn and Acid reflux
- Tender coconut water helps calm the irritation and the digestive system.
- Ash gourd juice detoxifies the digestive tract and relieves heartburn.
- Buttermilk- After a spicy meal, it can reduce the discomfort caused by heartburn.
- Drinking lukewarm water after every meal.
- Using ginger more often in cooking or drinking ginger-boiled water to aid digestion. Ginger is known for its alkaline nature.
- Bananas, cucumber, and Greek yogurt give immediate relief. Yogurt is a probiotic that improves the overall gut health.
- Boil mint or basil leaves in water and drink.
- Skim milk, preferably cold or milk at room temperature, helps reduce acidity in the stomach due to its Calcium content.
- Lemon water- Lemon, being a citrus food, can serve as a remedy when diluted with water and mixed with honey. It provides an alkalizing effect and can neutralize stomach acid.
9. How to Prevent the Symptoms of GERD and Acid Reflux?
Acid neutralizers and acid blockers may help reduce symptoms of the disorder but don’t give a cure to the disease. Cure means addressing/ resolving the root cause of the disease so that it doesn’t return. As discussed earlier, making lifestyle and diet changes is integral to preventing or managing symptoms of GERD and Acid reflux.
- Losing weight, if overweight, and maintaining a healthy Body Mass Index (BMI)
- Quitting smoking
- Avoiding foods that trigger GERD symptoms like fatty meats, spicy foods, acidic foods, carbonated beverages, processed foods, chocolates, drinking coffee, and fried foods (certain trigger foods may vary depending upon the individual)
- Following a low-carb, low-fat diet
- Regular exercise
- Reducing stress, relaxing the body and mind
- Reducing medications that cause acidity as much as possible.
- Early breakfast and dinners (always much before bedtime). It is recommended to have the last meal at least 2-3 hours before going to bed to have a positive impact.
- Avoiding frequent meals with more quantity. Eating smaller meals frequently is a suggested option. This idea is reiterated in the biomechanical theory of the Gastrointestinal Tract and Digestive mechanics, according to which frequent and prolonged stretching of the stomach walls occurs due to having large meals and air accumulation in the fundus (dome-shaped part at the stomach entrance). This often weakens the mechanisms that manage the opening and closing functions of the LES.
- Intermittent fasting (after consultation with a gastroenterologist) to regulate the digestive mechanism.
10. Way Forward
Although there are plenty of drug solutions that provide immediate relief, some studies point out the adverse effects of prolonged drug treatment for GERD and Acid reflux.
Blocking or neutralizing stomach acids may disrupt normal digestive functions since it generally works in a narrow range of pH that changes during different stages of digestion. The absorption of vitamins, minerals, and proteins occurs mostly only within that specific pH range.
As a consequence, even an excellent diet doesn’t help if the stomach acids are too low as everything depends on digestion and absorption. This could also mean we could be starving our bodies unintentionally.
If the right environment and sufficient time are given to the body to heal, the disease will gradually heal itself. Having a proper lifestyle and balanced diet will not only help in curing GERD but also any kind of lifestyle diseases that are predominant in today’s modern world.
Last Updated on by Gautam
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