Tips to avoid holiday heartburn: eat moderately, skip mints and acidic foods, minimize stress, take a walk, chew gum

webmd.com

The six weeks from Thanksgiving to New Year's Day is often filled with large meals, decadent treats and festive beverages -- a perfect storm for the one in five Americans who suffer from heartburn, or acid reflux.

Heartburn is an irritation of the esophagus caused by stomach acid. A registered dietitian at Houston Methodist Hospital, Kari Kooi, offers some tips on how to avoid heartburn during the holidays:

• Skip the after-dinner mints. Peppermint relaxes the muscles between the stomach and esophagus, which can allow stomach acid to flow back into the esophagus.
• Avoid tomato-based products, citrus fruits and juices, spicy cuisine, high-fat foods, chocolate, alcohol and caffeinated beverages, which are known triggers for heartburn.
• Chew gum. This alleviates heartburn by stimulating acid-neutralizing saliva, which helps to clear the acid from the esophagus. Fruit or cinnamon-flavored gum is best.
• Minimize holiday stress even while you are eating. Take a few slow, deep, rhythmic breaths before eating and then eat slowly and mindfully.
• Take a short walk after eating to help gastric juices to flow in the proper direction.
• Wait at least two hours after eating before lying down.
• Eat smaller portions and skip the seconds.

Common heartburn medications are linked to heart attacks

Research made possible by data mining reveals evidence that a common group of heartburn medications is associated with a greater risk of heart attack, according to Stanford University researchers, Lenny Bernstein reports for The Washington Post.

The heartburn drugs in question are known as proton-pump inhibitors, such as Nexium, Prilosec and Prevacid. Bernstein writes that "they are some of the most widely used drugs in the world and that an estimated 113 million prescriptions for the drugs are written for them around the world each year."

Bernstein notes that the Stanford study, published in the online journal PLOS One, recognizes that it was not designed to show cause and effect, and agrees that a large, prospective clinical study could establish whether the drugs are actually causing more heart attacks.

But one of the authors of the study, Nicholas J. Leeper, an assistant professor of cardiovascular medicine and vascular surgery at Stanford, told Bernstein that the U.S. Food and Drug Administration "should be aware of these findings" and "we do think patients should think about their risks and benefits and should discuss their risk with their doctor."

Nigam Shah, lead author of the research, cautioned that because some of these drugs are now available over the counter, it is important to tell your physician if you are taking them.

The research combed through 16 million electronic records of 2.9 million patients in two separate databases (one database was from hospital patients and the other from private office or clinic patients) and found that people who take the medication to suppress the release of stomach acid are 16 to 21 percent more likely to have a heart attack, Bernstein reports.

The research theorizes that proton pump inhibitors may reduce production of nitric oxide from cells that line the inside of the circulatory system, including the heart. Lower levels of nitric oxide have long been associated with cardiovascular problems, Leeper told Bernstein. This theory is being tested in the lab.

The Stanford study found no association between medications that combat heartburn by blocking histamine production, like Zantac and Pepcid, and increased risk of heart attack.

Heartburn on the rise, driven by overeating; avoid minty antacids

As overeating has become more common, Americans have been suffering from a lot more heartburn, the American Gastroenterology Association has found. About 25 million people say they experience daily symptoms of acid reflux, up from 15 million a decade ago, with another 60 million saying they have heartburn once a month.

"Blame stress and an aging population — and above all, experts say, blame Americans' habit of eating too much," reports The Courier-Journal's Anita Creamer.

Though it can occur at any age, acid reflux is most common in middle age. It is caused when acid backwashes into the esophagus while a person is digesting, the result of the sphincter muscle at the top of the stomach being weak. Acid reflux, which can cause heartburn, nausea, coughing and hiccups, can be especially common at night if a person goes to bed with a full stomach. "Anything that increases stomach pressure increases reflux," said Dr. Ronald Hsu, a gastroenterologist at Sutter Roseville (Calif.) Medical Center. "People who are more obese have more symptoms. Pregnant women can have more reflux."

To get relief, avoid mint-flavored antacids. Mint relaxes the valve between the stomach and esophagus, compounding the problem. Losing weight can help. So can avoiding chocolate, citrus fruits, alcohol, caffeine or spicy foods. Over-the-counter medications like Prilosec and Prevacid can block the release of stomach acid and provide relief.

People who regularly have acid reflux are more prone to developing esophageal cancer, which has been relatively rare but is difficult to treat and is quickly becoming more common. Most at risk are middle-age and elderly men who have long suffered from acid reflux and often are obese. (Read more)