Avoiding Holiday Heartburn

November 22, 2006

By Lucy Williams, Ivanhoe Health Correspondent

ORLANDO, Fla. (Ivanhoe Newswire) -- Rich holiday foods may taste good, but they can make you feel miserable. Fatty meals and sugary treats can lead to painful acid reflux, but there are ways to enjoy the holiday feast and avoid heartburn.

Fat and sugar trigger acid reflux because they weaken the esophageal sphincter. This muscle at the end of the esophagus acts as a one-way valve to the stomach. Normally, this muscle relaxes when you swallow to let food enter your stomach. It closes to prevent stomach acid from reentering the esophagus. Fat and sugar can inhibit the function of this valve.

Fatty foods also delay emptying of the stomach. Food sits in the stomach longer than it ordinarily would. The combination of food in the stomach and a weak muscle at the end of the esophagus can lead to acid reflux. Large, fatty holiday meals can quickly trigger acid reflux problems.

But you don't have to go hungry just because you're avoiding discomfort.

"I think the best advice I can give you is to do everything in moderation," Stuart Spechler, M.D., professor of internal medicine at University of Texas Southwestern Medical Center in Dallas, told Ivanhoe. "I wouldn't say, 'don't enjoy the holidays,' but eat things in moderation and try to minimize the intake of fatty foods."

Pop a Pill
Dr. Spechler said histamine H2-blockers can bring relief to those with mild acid reflux problems by slowing the production of stomach acid. Several histamine receptor blockers can be found over-the-counter, like Pepcid, Tagament, Zantac and Axid.

"If you know you get heartburn and you know eating fatty foods will precipitate heartburn, you can get some of those medications and take it a half-hour before the meal and it might help to prevent heartburn," Spechler said.

Make Simple Substitutions
Traditional holiday foods don't have to make you miserable if you suffer from acid reflux. Registered dietician Sara Simard of Johns Hopkins Bayview Hospital in Baltimore pinpointed some meal pitfalls and simple substitutions:

	Turkey: Opt for light meat over dark meat when picking your portion.
	Gravy: Use chicken broth or fat-free gravy to moisten your turkey and stuffing. For a refreshing twist, try a cranberry or mango chutney.
	Vegetables and other side dishes: Moisten foods with stock broth instead of extra fat.
	Desserts: Instead of using heavy cream or whole milk, substitute with an evaporated skim milk. Also, sugar substitutes like Splenda or Equal could be used to sweeten desserts.

"Keeping the food lower in fat and lower in sugar will help prevent heartburn," Simard said.

Practice Moderation
Eating too much can overextend the stomach and weaken the esophageal sphincter, possibly leading to acid reflux. Simard offered a few suggestions to keep your appetite and consumption under control:

	Eat small meals throughout the day of the holiday party or main meal to control hunger and prevent overeating at the main event.
	Skip second helpings. Monitor your appetite so you don't overstuff your stomach. Slow the rate of eating and savor every bite. This will help trigger fullness.
	Grab a small plate instead of a large plate. It's easier to control portion sizes when you have space limitations on your plate.
	Get chatty. Think of holiday meals and parties as social events. People eat less when they're talking.

Take a Hike
After a large turkey dinner, it's tempting to stretch out on the couch for a nap, but this can make acid reflux worse. If you lie in a horizontal position following a meal, stomach acid is more likely to reenter your esophagus and cause heartburn.

"When you eat a big meal, try to not go to sleep or lie down immediately after that meal," Spechler said. "Try to stay upright for a couple of hours. That helps."

Staying awake and on your feet has additional benefits. By taking a brisk walk after dinner, you can offset some of the calories consumed at the holiday feast.

SOURCE: Ivanhoe interview with Stuart Spechler, M.D., University of Texas Southwestern Medical Center; Ivanhoe interview with Sara Simard, R.D., Johns Hopkins Bayview Hospital

This article was reported by Ivanhoe.com, who offers Medical Alerts by e-mail every day of the week. To subscribe, go to: http://www.ivanhoe.com/newsalert/.

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