Let’s talk about Heartburn’ by Dr Harold Gunatillake

Nobody escapes the experience of at least one episode of heartburn in one’s life. It is very common in infants and they do suffer with it. Keeping and holding the kid upright is essential in such an eventuality.

What is heartburn? It has nothing to do with the heart. The burning feeling comes in the lower gullet which lies behind the heart in the thoracic cavity and you get the feeling that your heart is burning.

How does this happen?

The inner lining secretes acid juice to assist preliminary digestion of food and this fluid is not tolerated in your gullet inner lining (mucosa). To prevent reflux of acid juice and digesting food there is an efficient valve system at the junction of the stomach called the cardia and the lower oesophagus, at the level of the diagram a partition between the thoracic and abdominal cavities. This valve is given the name lower oesophageal sphincter. Obesity seems to be a major factor that causes this problem.

What are the foods that trigger heartburn?

• Eating large amounts of food is taboo if you suffer from heartburn. Further, you need to have your dinner at least two hours before retiring to bed. Placing at least two pillows behind your head in bed to sleep prevents acid reflux.
• Eating smaller portions of food is advisable, like the Chinese, do. Eating your breakfast quickly and then going to work may increase the risk of heartburn, too. Eat slowly is the solution.
• High fatty foods take a long time to digest and remains in the stomach for a longer period. Eating a large bun from MacDonald’s will give you that experience.
• Certain foods when prepared simply by boiling vs. frying may help to prevent heart burn. For instance, shrimps are broiled without being fried may not give heartburn. Roasted foods seem to give you heartburn. Trimming the fat off meat also helps.
• Low acidic foods like tomatoes, citrus fruits like oranges and lemon, or pickled foods with vinegar may start an episode of heartburn. Alcohol being acidic could be a culprit. The trick is to combine your favourite acidic food with non-acidic food such as rice, pasta and vegies, and eaten in small amounts may help to prevent heartburn.
• Coffee could be a culprit, including caffeinated tea and carbonated drinks Caffeine seems to increase acid in the stomach. Herbal teas, milk and water are good choices to avoid heartburn.
• Those chocolate addicts may have to give up eating them. Eating chocolate on empty stomach or after heavy meal can trigger an episode.
• Spicy foods including garlic and onions may trigger an attack. This is unfortunate because the staple food of Sri Lankans being rice and spicy curries are deprived part of their inheritance. Yet, if you reduce the quantities of spices you may be lucky to avoid heartburn.
• Chewing gum though a bad habit secretes more alkaline saliva when swallowed may neutralise the acid juice and may give relief. On the other hand you should avoid peppermint and mint gum.
• Drinking an antacid like Mylanta or similar supplements with aluminium hydroxide, or a glass of cool milk may help to avoid an episode after eating spicy food. Just an idea.
All the above foods may not trigger in an attck, who suffer from this malady. Some are lucky to escape from some of them.

There are certain medications like aspirin, anti-inflammatories like ibuprofen can bring about heartburn and be aware.