Dietary Tactics to Alleviate Indigestion and Heartburn

Many North Americans have indigestion occasionally, but for some, it is a daily trial. Indigestion is a general term to describe discomfort in the upper abdomen after a meal. It’s not a disease itself, but a description of symptoms.

Although indigestion is often used to describe heartburn, these are two different conditions. Heartburn is the burning, painful sensation in the chest that occurs when stomach acid and other contents flow backward, or reflux, into the esophagus.

When acid reflux and heartburn occur at least twice a week, a person may be diagnosed with Gastroesophageal Reflux Disease, or GERD. Over time, GERD damages the lining of the esophagus and may even cause a precancerous condition known as Barrett’s esophagus. People with GERD may require stronger medications or surgery to treat symptoms.

Indigestion can be caused by GERD, peptic ulcer disease, gastritis, cancer, or abnormality of the pancreas or bile ducts. Heartburn may be caused by obesity and pregnancy, both of which increase pressure on the stomach and force fluids up into the esophagus. Another possible cause of heartburn is a hiatal hernia, which develops when the upper part of the stomach protrudes through the hiatus, the opening where the esophagus meets the stomach.

Nutrition Connection
Dietary tactics and modifications can alleviate symptoms of indigestion and heartburn. Here are several recommendations:
-Eat small, frequent meals. You may be able to digest five to six smaller meals better than three large ones. Avoid eating within 2 hours of bedtime.
-Eat a balanced, low-fat diet. The stomach will digest a low-fat diet that offers a balance of protein, starches, and fiber-rich vegetables and fruits more easily than fatty foods, which take longer to digest and thus slow down the rate of food emptying from the stomach.
-Avoid acidic foods and drinks. Coffee, including decaffeinated brands, promotes high acid production; so do tea, cola drinks, and other sources of caffeine. Acidic foods include citrus fruit, tomatoes, pickles, and anything made with vinegar.
-Avoid spicy foods. Omit from your diet other foods that tend to irritate your stomach or provoke bouts of indigestion. Avoid curries, hot peppers, and any other offenders that cause discomfort.
-Avoid foods that relax the diaphragmatic muscle. Chocolate or peppermint worsens indigestion by relaxing the sphincter muscle connecting the esophagus to the stomach.
-Limit alcohol intake. Alcohol can irritate the stomach lining.
-Dine earlier in the evening. If you give yourself at least 3 hours between dinner and bedtime, your stomach is more likely to be empty when it’s time to lie down, so reflux is less likely to occur.
-Chew nonmint gum for dessert. In the case of GERD, chewing gum stimulates you to produce more saliva, which contains bicarbonate. Gum chewing also increases your rate of swallowing. The saliva then neutralizes the acid in the esophagus—so you’re activating nature’s own antacid system. However, mint gums may cause the lower esophagus to relax, potentially allowing more stomach acid to rise.

Beyond the Diet
Indigestion and heartburn caused by reflux can usually be controlled with a few lifestyle changes. The following tips can help:
-Exercise. In addition to contributing to overall health, exercise helps reduce stress, a potential cause of indigestion.
-Don’t smoke. Smoking increases stomach acid levels, and nicotine relaxes the sphincter muscle, which causes acid reflux.
-Sit up straight after meals. Bending over or lying down increases pressure on the stomach and promotes acid reflux.
-Maintain a healthy weight. Extra weight around the abdomen pushes up your stomach and causes acid reflux in your esophagus.
-Don’t wear tight-fitting clothes. Clothes that are too snug around the waist place additional pressure on your stomach. -Elevate your head at bedtime. If heartburn strikes frequently at night, raising the head 3 to 6 in (8 to 15 cm) can help symptoms.
-Sleep on your left side. This helps reduce pressure on your stomach, which is likely to reduce the chance of reflux.
-Track your triggers. You have to know which foods trigger your symptoms—foods that work well for one person may cause problems for another. Common foods that trigger GERD include chocolate, caffeinated beverages, and alcohol. Keep a journal to note your symptoms; as you list foods and beverages for each meal, also note what else is going on. Write down symptoms and their frequency. Your diary should also note all medications taken, including supplements. Your doctor should review this diary to help identify specific contributing factors.
- Take an antacid. An over-the-counter antacid can soothe heartburn and indigestion symptoms. However, the use of antacids to treat heartburn by neutralizing stomach acid is questionable. The problem is not too much acid, but acid in the wrong place. If they do help, follow instructions and never take them for longer than recommended. Overuse may cause diarrhea or constipation.
-Talk to your doctor. If all else fails, speak to your physician, who may run some tests or take x-rays to determine whether you have GERD or to rule out other diseases. Prescription-strength drugs, which include H-2 receptor blockers and proton pump inhibitors, may be suggested.