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Eat well, then let gravity do its job BRIGHT EATING >>

July 6, 2008 12:16 am

ABOUT HALF of Am- ericans complain of heartburn monthly, and about 7 percent have it daily, according to surveys.

Luckily, there are several home remedies and eating changes that reduce reflux pain. Still, if you are having any severe pain or are suffering from heartburn twice a week or more, do visit your doctor.

Heartburn pain is usually worse after meals and when bending over or lying down. The pain actually has nothing to do with the heart--it's caused by stomach acid splashing upward into the esophagus, or throat.

It's important to pay attention to heartburn--long-term indigestion can lead to pre-cancerous changes of the throat and difficulty swallowing. This can be prevented by taking medications that ease the burning feeling.

Also, other problems can masquerade as heartburn, such as heart attacks, ulcers, gallstones and other problems that a doctor can diagnose and treat.

Heartburn is not a normal part of life or growing older, as many believe.

GOOD POSTURE

If you have mild heartburn, consider changing your lifestyle. A recent study showed that the two most effective things you can do to reduce reflux are to ele-vate the head of your bed and avoid overeating.

Raising the head of the bed uses gravity to keep stomach acid down where it belongs, in the stomach. Try raising the head of your bed 4 to 8 inches by placing blocks or bricks under the legs.

If your bed is on castors, try attaching jar lids to the blocks to cup the wheels and prevent your bed from rol-ling off the blocks in the middle of the night, according to the American College of Gastroenterology. An alternative is to use an 8- to 10-inch foam wedge underneath your mattress. Don't prop up your head with pillows--this crunches your stomach and may worsen reflux.

Other tips:

Try to sit or stand upright for three hours after eating--again, let gravity work for you.

When you do lie down to sleep, lie on your left side. This position cradles the curved top of the stomach upward, reducing the risk of reflux, research shows.

Exercise. Another study showed that mild exercise, such as walking 30 minutes a day, reduced heartburn.

Use common sense when eating. Don't eat past the point of fullness. Studies show that the larger volume of food people eat, no matter what foods, the more likely they are to suffer heartburn.

Along the same lines, choose loose-fitting clothes. Cinching your belt tight is only going to put more pressure on your stomach.

EAT SENSIBLY

A lot of the research on food is contradictory--some studies show fatty, spicy foods increase heartburn, and some do not.

Many people swear that acidic foods such as tomatoes and oranges make their reflux worse. (This seems strange to me, because stomach acid is 10 to 100 times stronger than orange juice.)

Other common advice is to avoid alcohol, regular and decaffeinated coffee, chocolate, carbonated drinks, spices and mints, all of which may irritate or relax the esophageal sphincter. That's the ring of muscle that clenches the stomach closed, keeping the acid safely inside the stomach.

American and Swedish studies suggest that people who eat more fruits, vegetables and fiber are less likely to have reflux.

A small Australian study showed that people who followed simple advice for one month felt significantly better. They didn't lie down for three hours after eating, and ate small frequent meals low in fat, spices, citrus and other trigger foods.

Of 21 people, eight were "cured," another eight had symptoms only if they broke the rules, and five reported reduced symptoms. These sound like good odds to me.

Other research suggests that quitting smoking can reduce reflux.

And for many people, stress can trigger or worsen reflux. Consider daily relaxation exercises, or seek counseling temporarily.

Children who have reflux that does not respond to the usual medications may have eosinophilic esophagitis, a rare type of food allergy that can be diagnosed by an allergist. It may require avoiding certain foods; the foods are different for each person.

MEDICINE HELPS MANY

For most people, if changing daily habits for a week or two doesn't help, medications will help. Most reflux medications either neutralize or reduce stomach acids.

However, taking these medications long-term may block absorption of some vitamins and minerals, particularly calcium, folate, iron and vitamin B-12. For example, people taking prescription proton pump inhibitor drugs had a higher risk of breaking a hip, possibly because the medication made it harder for them to absorb calcium and vitamin D.

Don't stop taking your medication unless your doctor approves. If you need to stay on reflux medication, ask your doctor about taking a daily multivitamin-mineral. You also might take a calcium citrate supplement--this form of calcium can be absorbed without stomach acid. You also could ask your physician whether you need a blood test of your vitamin B-12 and vitamin D levels.

Whether it's with medications or just lifestyle changes, you can eat without pain.

Jennifer Motl welcomes reader questions via her Web site, bright eating.com, or mailed to Nutrition, The Free Lance-Star, 616 Amelia St., Fredericksburg, Va. 22401.