Americans celebrate with food and lots of it. Those big holiday dinners, the parties, happy hours, and shopping sprees -- we love that stuff.
So what's the problem? It's a big fat recipe for a bad case of heartburn. Alcohol, caffeine, -- plus eating too much rich, fatty food - is a slippery slope to indigestion. The holiday dinner is especially a problem. Once you've stuffed yourself, then moved to the couch, you're in trouble.
A physical exam for hiatal hernia is similar to that for heartburn, with two additions: X-rays may be ordered to show the hernia, and if anemia is a concern, a blood sample may be taken to check your red blood cell count.
A hiatal hernia can be diagnosed with a specialized X-ray study that allows visualization of the esophagus and stomach (barium swallow) or with endoscopy (a test that allows the doctor to view the hernia directly). An esophageal manometry test (pressure study) may also be performed...
"We all want a really full stomach by the time the football game comes on," says John Affronti, MD, a professor of gastroenterology at Emory University School of Medicine in Atlanta. "But when you kick back in the La-Z-Boy recliner, you're tilting the stomach - which allows stomach acid to spill into the esophagus."
Heartburn is partly a mechanical problem, Affronti explains. There's a little muscle that controls all of this that sits between the esophagus and the stomach. That muscle gradually relaxes as we get older -- which means stomach acid has easier access to the esophagus.
When we're standing, gravity helps keep stomach acid from migrating upward. But when we go horizontal -- and especially when a full stomach is applying internal pressure -- stomach acid gets pushed into the esophagus. Extra pounds around your waistline only add to that internal pressure.
Also, excess fatty food means digestion slows to a crawl, which makes heartburn a virtual certainty, explains Affronti.
Taming the Heartburn Beast
Run-of-the-mill heartburn is easy to treat, says Braden Kuo, MD, a gastroenterologist at Massachusetts General Hospital in Boston.
"This is particularly relevant at holiday times, where there is increased use of alcohol, after-dinner mints, desserts, and the overstuffing of the GI tract," he tells WebMD. "All these factors can make heartburn worse. There's nothing wrong with treating it more aggressively with OTC or prescription medicines during those times."
For best results, take your heartburn medicine before heartburn starts - before sitting down to that big holiday meal or heading to the party buffet, he advises. You have a lot of options from which to choose: