For people with heartburn, vacations have many perils: unusual foods, irregular meal times, and our very human urge to overindulge.
"When people are on vacation, they eat a lot, they drink a lot, and they don't sleep much," says David Carr-Locke, MD, director of endoscopy at Brigham and Women's Hospital in Boston. "Unfortunately, for people with GERD, that can bring on symptoms."
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...
But everyone deserves to cut loose -- at least a little -- when on vacation. So here are some tips on how to have fun and keep your heartburn symptoms at bay.
Eat sensibly. "I know it sounds like no fun," says Lawrence J. Cheskin, MD, co-author of Healing Heartburn, and associate professor at Johns Hopkins School of Medicine. "But you should still try to eat carefully when you're on vacation, just like you would at home."
This doesn't mean you have to eat crackers and white rice while everyone else savors the local cuisine. Just don't gorge on heartburn triggers, such as high-fat foods, says Carr-Locke.
Drink moderately. Alcohol is a common trigger for many people with GERD. So don't overindulge -- especially in drinks mixed with citrus juices, another drink that can bring on GERD symptoms.
Don't go a long time between meals. In general, people with heartburn should try to eat frequent, small meals. So don't get so hungry you wind up gorging yourself; that's likely to cause heartburn. Try to build in regular snacks throughout your day.
Wear loose clothing. Sure, you want to look good on vacation -- but don't force yourself into a favorite bathing suit or outfit if it's too tight. The pressure of restrictive clothing can bring on heartburn symptoms. Instead, dress in something that is loose-fitting and comfortable.
Get enough sleep -- but don't spend the whole vacation lying down. While staying up late and not getting enough sleep can bring on heartburn symptoms, so can sleeping too much, says Carr-Locke. When you lie down, acid can more easily back into your esophagus. To get around this problem, try propping up your hotel bed or sleeping on a pile of pillows, says J. Patrick Waring, MD, a gastroenterologist at Piedmont Hospital in Atlanta.
Pack your medication. It should be obvious, but before you leave the house, double-check you have the medicine you need, says Cheskin. If possible, pack extra just in case.
Plan ahead. If you just know that you're going to wind up eating and drinking a bit more than you should, take precautions.
"It would be better not to overdo it," says Cheskin, "but if you know you're going to have a big meal anyway, it's better to take your medications before you go out instead of waiting until after you have heartburn." Ask your doctor if doubling up on your medicine might make sense.
While taking precautions against heartburn may seem like a drag, remember that your vacation will be more fun because of them.
SOURCES: American Gastroenterological
Association web site, "Heartburn." David Carr-Locke, MD, director,
endoscopy, Brigham and Women's Hospital, Boston. Lawrence J. Cheskin, MD, FACP,
coauthor of Healing Heartburn; director and founder of the Johns
Hopkins Weight Management Center. J. Patrick Waring, MD, gastroenterologist,
Piedmont Hospital, Atlanta.