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November 6, 2006

A University of Michigan Health Minute update on important health issues.

Holidays and heartburn: Tasty treats may trigger acid reflux

U-M expert offers tips to avoid serving up heartburn with holiday meals

ANN ARBOR, MI – Whether it’s thoughts of sugarplums, turkey and mashed potatoes covered in gravy, sweet potatoes, or pumpkin pies with whipped cream dancing in your head, no holiday celebration would be complete without food – and lots of it.


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But some tasty holiday treats may leave you reaching for the antacids instead of another turkey drumstick. And for the 15 million Americans who experience chronic heartburn, or Gastroesophageal Reflux Disease (GERD), the holidays can be especially painful.

“The holiday season is clearly one of the worst times of the year for patients with GERD,” says William Chey, M.D., a gastroenterologist at the University of Michigan Health System. “The large amounts of food we eat during the holidays, and the types of food served during the holidays – especially fatty and caffeinated foods – can be a recipe for disaster for chronic heartburn sufferers.”

GERD is a common digestive condition caused by a relaxed or weakened lower esophageal sphincter – the muscular valve between the esophagus and the stomach – that is unable to prevent stomach acid from flowing up into the esophagus.

After eating, people with GERD will often experience a burning feeling in their chest, similar to heartburn, as well as a sour taste in their mouth as a result of the stomach acid in the esophagus.

Lifestyle changes – not eating certain foods and avoiding large meals – can help relieve some of the symptoms of GERD.

But avoiding holiday food temptations is not always easy. To help people with GERD survive the holidays, Chey dishes up some advice to keep your stomach and esophagus merry and acid-free.

Chey’s five tips for surviving the holidays with GERD

  • Don’t overeat: “Large amounts of food distend, or stretch the stomach, which can cause the lower esophageal sphincter to relax and release acid back up through the esophagus,” says Chey.
  • Stay caffeine-free: Caffeinated beverages and foods like soda pop, ice cream and chocolate will work to aggravate symptoms of GERD.
  • Avoid fatty, greasy foods: Foods that are f-a-t-t-y will only spell trouble for people with GERD. “Excessive fats in foods work to slow the process of food leaving the stomach. If food isn’t emptied from the stomach, it can backup into the esophagus,” says Chey. In addition, he notes, fatty and greasy foods promote relaxation of the lower esophageal sphincter, allowing acid rise into the esophagus.
  • Keep the wine in the bottle: Chey says research has consistently shown that red wine can cause heartburn. White wine, too, may cause acid reflux -related symptoms.
  • When you eat is as important as what you eat: The time of day you eat can have an impact on acid reflux disease. “Gravity actually serves as an important barrier for acid reflux during the day. So when you lie down at night after eating a meal, you no longer have that gravity barrier to prevent acid reflux,” notes Chey. For people who tend to have nighttime acid reflux symptoms, Chey recommends that they avoid eating or drinking three to four hours before bedtime.

Treating GERD
Over-the-counter antacids are some of the most widely used products to relieve the symptoms of heartburn.

Health Minute Image“Antacids are a very attractive option for heartburn sufferers because they provide immediate relief,” says Chey. “The problem, however, is that the affects of antacids are short-lived, and there are some side-effects associated with their use such as diarrhea or constipation, particularly if you ingest a large amount.”

Another group of over-the-counter medications that provide fast relief are called Histamine 2-Receptor Antagonists, which include medications such as Pepcid® or Zantac®. While these medications have longer-lasting affects than antacids, Chey says they offer only modest benefit for patients with frequent and severe heartburn symptoms. And, he warns, that overuse of such medications may lessen their effectiveness in some patients.

The most effective options for people with acid reflux disease, however, are Proton Pump Inhibitors (PPI). PPI include Prilosec™, which is available over-the-counter, or prescription strength alternatives, available from your doctor.

“While these drugs don’t work as quickly as other over-the-counter options, they are by far the most potent drugs in terms of suppressing acid production by the stomach, and relieving acid reflux symptoms,” says Chey. “They’re also good to use before a big meal, such as Thanksgiving dinner, to help prevent symptoms of acid reflux.”

For more information, visit these Web sites:
UMHS Health Topics A-Z: GERD

UMHS Health Topics A-Z: Heartburn

American Gastroenterological Association: Heartburn

American College of Gastroenterology: GERD

Written by Krista Hopson


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