Monday, November 16th, 2009

Heartburn

Heart BurnThe kind of lives we are living these days is hard to digest for our stomachs. The latest fallout of the urban lifestyle is the heartburn. Three in five urban Indians suffer from heartburn, a study done by an NGO Healthcare Welfare Society finds. The survey also finds that eating out – that is eating spicy food, processed food and junk food – is a huge factor in 25-40 per cent of those surveyed who have heartburn.

Heartburn is primarily a mechanical problem. When you swallow food, it travels down the esophagus and enters the stomach via a small, muscular valve.Normally, the valve then closes and stays shut. But sometimes it becomes weak and floppy and doesn’t close properly. That’s when trouble begins: Food and stomach acids gurgle back up into the esophagus — a condition known as acid reflux.

Heartburn has nothing to do with heart and everything to do with what we eat and how we cope with stress. Heartburn can strike anyone, but women suffer more often than men, and pregnant women are especially susceptible. So are people who are confined to bed rest for a long period of time. Weight is another key risk factor, and it doesn’t have to be extreme. If your weight is normal, but at the upper end of the healthy range, your chances of having frequent heartburn are higher, reported the Harvard Nurses’ Health Study.

Tame heartburn

  1. Losing weight if you are overweight, helps cure heartburn.
  2. Drink plenty of water to neutralise acid.
  3. Elevate the head of your bed. If your heartburn kicks in during the night put gravity to work by keeping your esophagus higher than your stomach, so stomach acid cannot flow up.
  4. Putting grandma’s wisdom at work, sleep on your left side to reduce the reflux, and to think of it, the Stanford review has rediscovered what grandma always knew.
  5. If you smoke or drink alcohol, leave that.
  6. Too much tea and coffee is bad, of course
  7. Eat smaller meals and go for early dinner.
  8. Figure out your triggers then avoid them. Fried or spicy foods, coffee, citrus, sugar, chocolate, soda, tomatoes and onions are common culprits.
  9. Meditation in the form of visualization not only eases stress but heartburn too.
  10. Picking the right medication. If you have only occasional or mild heartburn, an over-the-counter antacid can deliver temporary relief.

Going natural

For treating heartburn naturally, try maintaining an acid-alkali balance of 20:80.

  • Start taking coconut water, cucumber juice because these are alkaline.
  • Besides, intestinal toxins can be counteracted with benign and protective lactic acid — present in buttermilk and yoghurt.
  • Avoid eating fruits after having meals.
  • Usually a teaspoon of baking soda mixed in a glass of water will help most people, since it neutralises excess acidity. This is one of the most natural ways to cure heartburn

If a combination of lifestyle changes and antacids do not ease your heartburn, stronger medications are required.

While the stomach is protected from this strong acid, the esophagus isn’t as well protected. Its sensitive lining can be irritated or injured by the acid Repeated irritation of the food pipe caused by the stomach acids changes the type of cells in the outer lining of your food pipe. Over a period of time, this could lead to an abnormality in the growth of cells. And any abnormality in the growth of cells is cancer.

Treatment options

  • Proton pump inhibitors are the first line of treatment for persistent heartburn. It blocks the enzyme in the wall of the stomach that produces acid. By blocking the enzyme, the production of acid is decreased, and if the reflux happens it will be bland in nature, thereby not damaging esophagus. They are very effective and are typically taken only once a day. These drugs are usually only prescribed if other drugs have not helped.
  • Prokinetic medicines: These are medicines that both help strengthen the valve, thereby stopping acid from refluxing up into the esophagus, and speed up the passage of food through the stomach.

Though the drugs are safe they cannot be used forever. Laproscopic fundoplication is the standard surgical treatment for curing heartburn, especially for young patients who need prolonged therapy. The faulty valve is stitched thereby putting a stop to the reflux of acid.

Dr. Anil Arora, senior consultant Gastroenterology, Ganga Ram Hospital, New Delhi.

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