I am a 44-year-old who works both in and outside the home. I suffer from recurrent bouts of heartburn. What treatments are available?
Conventional remedy:
Heartburn, a feeling of burning discomfort in the chest, often associated with an acid taste in the mouth, is a common condition. At the point where the oesophagus meets the stomach is a ring of muscle that acts as a valve. If the valve is weak, it can allow the acid content of the stomach to travel back up the gullet and even into the throat.
Many factors contribute to heartburn. Eating too fast, taking medication such as aspirin and non-steroidal anti-inflammatory drugs and eating foods such as onions, curry and cucumber are all linked to heartburn, as are wine, beer, carbonated drinks and coffee. Pregnancy, obesity, stress and anxiety can all contribute to the condition.
Lifestyle and behavioural changes are often the key to controlling heartburn. If you are busy, you may be eating incorrectly. Try not to bolt meals. Avoid eating fatty or spicy foods or foods that "burn". Large meals are best avoided; instead, aim for regular small meals.
If you smoke, try to give up cigarettes, or at least reduce your consumption of them. Don't drink coffee, especially late in the evening, and reduce your alcohol intake. If you work hard and have children, it is often hard to find the time for yourself.
Relaxing for a short period after you have eaten will help you avoid the discomfort of heartburn, however. If you are overweight, try to lose a little. Avoid wearing tight clothes.
Above all, learn to identify triggers that bring on your heartburn and try to avoid them. Take steps to reduce stress. This may mean delegating tasks at work and at home to others. Use over-the-counter antacid preparations when heartburn occurs and at night, before retiring.
If after trying these recommendations you are not experiencing relief, it is important that you see your family doctor. He may wish to arrange for you to have tests to rule out other conditions, such as an ulcer.
If heartburn is confirmed, drugs such as a H2 receptor antagonist or a proton pump inhibitor, which decrease gastric acid and reduce the symptoms of heartburn, may be prescribed.
Dr Muiris Houston
Alternative remedy:
Heartburn is associated with imbalanced digestive juices, which in most cases means high acid levels, but it may also be present with insufficient levels of stomach acid. The types of food eaten, the manner in which they are eaten and anxiety and stress may all be factors.
Foods associated with heartburn include rich fried foods high in fat. Chocolate, alcohol and saturated fats lower the oesophageal sphincter, allowing foods to be regurgitated. Cow's milk can make acidity worse, as calcium can help increase acid levels. Fried meats, salty meat, salted fish, smoked foods, meat broth, hot spices and coffee will all increase acid levels, and they are best avoided by those who suffer from heartburn.
Eating too fast, eating on the run, not chewing food properly and gulping air while eating will all contribute to heartburn. Do not drink and eat at the same time if prone to indigestion. Ensure that you drink at least two litres of water a day, however, away from meals. Avoid drinking milk with meals.
Anxiety and stress are known to imbalance the alkaline-acid balance in the digestive tract. If suffering from them, eat lightly, keeping heavier meals until there is more time to eat properly.
During an attack of heartburn, a handful of blanched almonds or uncooked oat flakes may help restore the acid-alkaline balance. Freshly squeezed cabbage or potato juice may also help. Aloe-vera juice may help with overacidity. Digestive enzymes may help with indigestion. Lecithin granules may help if the problem is excess fat or fat digestion. If underacidity is suspected, getting relief from a spoon of cider vinegar may be an indicator. Another way of finding out if your acid levels are low is to eat cooked fresh beetroot and monitor your urine. If it is pink or red, you may have low acid levels.
Bacterial cultures in supplemental form may help restore the gut flora. Do not take them in the form of cow's milk.Yarrow juice is known to restore acid levels.
Always check with your GP if heartburn recurs, as it may be an indicator of more serious digestive disturbances.
Maria Costello, nutritionist
Maria Costello is a member of the British Association of Nutritional Therapists (00-44-870-6061284)