Tackling Holiday Heartburn

Holiday feasts are close to our hearts, all those favorite comfort foods. But why make heartburn part of the yearly tradition? Here's a game plan for tackling indigestion head-on.

From the WebMD Archives

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.

"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."

You know the result -- that slow-burning feeling that works its way upward. It's acid reflux, better known as heartburn. Sleeping With Heartburn Carries Cancer Risks.

The Mechanics of Heartburn

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:

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Here are some over-the-counter heartburn medicines:

  • Antacids like Tums and Rolaids neutralize stomach acid to relieve heartburn, sour stomach, acid indigestion, and stomach upset. These include Tums, Rolaids, and Maalox.
  • Acid blockers reduce the production of stomach acid. They include Axid AR, Pepcid AC, Prilosec OTC, Tagamet HB, and Zantac 75.

For severe heartburn that isn't relieved by these medications -- or for anyone who has been using them for more than two weeks -- prescription medicine may be necessary. The prescription forms of Axid, Pepcid, Prilosec, Tagamet, and Zantac contain higher doses than the OTC versions. Prescription versions of Prevacid and Nexium, as well as others, are also effective.

8 Tips to Control Heartburn

There's no getting around it -- to rein in heartburn, you simply can't eat so much, says Elaine Magee, MPH, RD. Magee is WebMD Weight Loss Clinic's 'Recipe Doctor' and author of the book, Tell Me What to Eat if I Have Acid Reflux.

"It's hard but once you get used to eating only until you're full, you get used to it," Magee tells WebMD. "It becomes much easier to stop at those holiday meals. You don't like that uncomfortable feeling anymore."

One trick, she says, is to use small plates. "At holiday parties, people tend to set out appetizer plates. Just don't pile lots of food on that little plate. I've seen people do that."

Magee offers a few more tips:

  • Know thyself. Know the foods that irritate your stomach, the ones that trigger heartburn, and steer clear of them. These tend to be onions, chocolate, citrus juices, tomatoes, soft drinks, coffee, alcohol.
  • Don't eat too close to bedtime. Stop eating four hours before you hit the sheets.
  • Be selective. If you don't like green bean casserole, pass it up. Go for what you really want but make it a moderate-sized portion.
  • Savor small bites. Think of yourself as a wine taster -- the first couple of sips are for tasting, savoring. Really experience the food. You don't need to eat a whole plate of coconut shrimp, eat just one.
  • Fix one plate, and don't pile it high. You want to save room for a sliver of dessert.
  • Ask for a to-go plate. Most hosts are more than happy to send food home with guests. You can enjoy the same delicious dinner again - the next day, when you're hungry enough to enjoy it.
  • Take a walk after dinner. It's a good habit to get into, because it helps food digest - which prevents heartburn.
  • Don't wear tight pants. Tight pants can keep appetite under control, which is certainly a plus. But they constrict your stomach, which makes heartburn more likely.

"I don't want to constantly remind myself that I'm supposed to lose weight, or that I'm overweight, or that I have to regulate myself," Magee tells WebMD. "I believe in eating when you're hungry, stopping when you're comfortable. That leaves room for enjoyment."

WebMD Feature Reviewed by Cynthia Dennison Haines, MD

Sources

Published Oct. 24, 2005.

 

SOURCES: John Affronti, MD, a professor of gastroenterology at Emory University School of Medicine, Atlanta. Braden Kuo, MD, a gastroenterologist; and director, motility laboratory, Massachusetts General Hospital, Boston. Elaine Magee, MPH, RD, WebMD Weight Loss Clinic's Recipe Doctor. WebMD Medical Reference with The Cleveland Clinic.

© 2005 WebMD, Inc. All rights reserved.

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