Ease the burn before it erupts

Is that a dragon getting ready to spit fire? No, it’s just your heartburn acting up again.

Almost everyone will experience heartburn at least once in their life, according to the American College of Gastroenterology.

Maybe it’s a rarity for you, only occurring after a big meal or an especially spicy one. For others, it can become a persistent and severe occurrence that develops into gastroesophageal reflux disease (GERD).

Regardless, health care providers encourage you to address the condition now before it burns you.

What is heartburn?

Heartburn is pain and/or irritation within the esophagus — the tube connecting your mouth to your stomach — as acidic fluid moves up from the stomach instead of down through the body as it should, explains David Cline, MD, internal medicine provider at MultiCare Maple Valley Clinic.

The body’s natural process to prevent heartburn includes the diaphragm muscle and lower esophageal sphincter, which uses gravity and a valve at the bottom of the esophagus to keep food and acid from moving back up.

Acid reflux generally occurs alongside heartburn and can feel like phlegm in the throat, causing you to repeatedly cough to clear it, Dr. Cline says. Many people also experience voice hoarseness as the acid hits the voice box.

“The more you cough can make it worse because of the strain on the valve, loosening it,” Dr. Cline says. “Additionally, once the esophagus gets irritated … it takes a while for it to heal. You may even get an ulcer in the lining of the esophagus, which could continue to hurt for a while after a bad episode.”

What causes heartburn?

Heartburn generally impacts people over the age of 40, Dr. Cline says.

The source of your heartburn can be a number of things, from what or how much you eat, your stress levels, overstraining your body or even how you relax.

For some, it could be an anatomical issue related to the esophagus valve, or a hiatal hernia — where the opening through the diaphragm is too loose. This kind of physical predisposition must be diagnosed by a gastrointestinal specialist with an endoscopy procedure, Dr. Cline explains.

Heartburn could also be the result of a medication such as over-the-counter anti-inflammatories (e.g., ibuprofen).

A full stomach is more likely to push acid up, Dr. Cline adds. Or if you recline or lie down after eating, you’re working against gravity to keep the acid down.

Highly acidic foods are a primary culprit regardless of how much you eat. Some of the most overlooked include traditionally spicy foods such as Thai, Indian or Mexican, tomato-based products like red sauces or ketchup, and garlic and onions.

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Additionally, consuming acidic drinks such as coffee, carbonated beverages, citrus juices and milk can cause heartburn, as well as alcohol — especially red wine.

Other circumstances, such as pregnancy, weight gain or persistent coughing (as with bronchitis), can loosen the esophagus valve and increase your likelihood of heartburn.

Fortunately, for most people heartburn is easy to treat with lifestyle changes — diet, exercise and, if needed, acid-reducing medication, Dr. Cline says.

Ease the burn

Understanding the source of your heartburn is the first step, and can often be done at home. Track when it occurs and what you were doing or consuming in the hours prior.

“You can neutralize acid with Tums and other oral antacid products,” Dr. Cline says. “Those have a base that is opposite of acid to neutralize it, and are safe if taken in moderation.”

But if you’re experiencing heartburn every day or after every meal, don’t rely on over-the-counter antacids, he warns. They’re high in calcium, which increases your risk of kidney stones. Some natural home remedies include licorice or baking soda mixed in water — but those aren’t a permanent solution, either.

“There are certain times you can’t avoid it,” Dr. Cline says.

Take your notes to your primary care provider and make a plan of action. Maybe that’s eliminating or reducing certain foods that trigger you, identifying better stress management practices or setting a weight loss goal.

Other tips:

• Chew food thoroughly
• Eat slowly
• Drink plenty of water while eating to dilute acid and aid digestion
• Stay upright for at least two hours after eating, or prop chest up with pillow
• Only eat until full

What if I just ignore it?

Ignoring your heartburn and the damage being done to the esophagus can have permanent consequences, including increasing your risk for cancer, Dr. Cline explains.

Once or twice a week is OK to treat at home, but if it’s more than that, see a provider, he says. They may recommend a higher level of medication than antacids, including antihistamines like Pepcid or a proton pump inhibitor like Prilosec or Nexium.

If your condition persists or gets worse after all treatment and lifestyle changes have been exhausted, expect to be referred to a specialist, Dr. Cline adds.