Over eating can have some painful consequence, Consultant Gastroenterologist Dr Tony Tham and Gastrointestinal Specialist Dietitian, Adele Nichol explain how to avoid heartburn during the Christmas period.

What is heartburn?

Heartburn is a symptom whereby patients complain of burning in the chest.

Why and how do people get it? 

Heartburn is whenever acid which is produced in the stomach refluxes or backs up into the oesophagus, which is the tube that carries food from the mouth to the stomach. This condition is called acid reflux. The medical term for this is gastroesophageal reflux disease.

Who gets it? 

Being overweight especially round the waist is a risk factor for reflux. The presence of a hiatus hernia is also a risk factor. This is a condition whereby the hole in the diaphragm is too large and the top part of the stomach pokes into the chest. Reflux can occur in up to half of pregnancies. Specific foods such as fat, chocolate, peppermint, caffeine, alcohol, smoking, can cause reflux. Some drugs and stress can also cause and aggravate reflux.

What foods over Christmas will casue heartburn?

People may be more likely to get heartburn over Christmas due to one or more factors below:

Ø Eating larger than usual meals with many courses

Ø Having richer food with a higher fat content, that will be slower to empty from the stomach

o   Roast potatoes, cream and butter in mashed potatoes, sausages, stuffing, gravy made from the juices of the meat, Christmas pudding, Christmas cake

Ø Having higher fat snacks e.g. crisps, chocolates, mince pies, nuts

Ø Having carbonated drinks

Ø Having more alcohol than usual

Ø If a smoker - smoking more than usual

How can we avoid it?

The first step is to understand what foods and lifestyle behaviour can aggravate reflux. The foods that can aggravate reflux has been described above. The public should try to moderate the intake of these foods not only over the Christmas period but in everyday life. We should also avoid drinking alcohol to excess and obviously stop smoking.

Measures that are generally accepted as being helpful are:

Ø Avoiding rich or fatty foods

Ø Limit the fat you use in cooking and at the table

Ø Avoiding highly spiced or known irritants

Ø Avoiding excess tea, coffee or alcohol

Ø Chewing foods well

Avoid eating late at night, Avoid smoking

Ø Don’t wear tight clothing

Ø Try to relax

Ø Eat smaller more frequent meals and avoid having the largest meal in the evening and chew food well

What misunderstandings do some people have about heartburn?

Many people put up with reflux for years, not realising that there are effective remedies for this (see answer to remedies below). Some people think that if you have acid reflux, staying on a bland diet is the only safe option. In fact, there are many spices that can be taken without causing reflux such as cumin, turmeric, rosemary, basil, ginger.

What are some remediesIncluding natural remedies and supplements?

The charity Campaign Against Reflux Disease advise the following lifestyle modifications: Stop smoking 2. Lose Weight 3. Give yourself at least a 3-hour gap between having a meal & lying down. 4. Prop up the head end of the bed by about 6 inches 5. Avoid excess coffee, chocolate, alcohol and peppermint. 6. Avoid acidic juices and carbonated beverages. 7. Chew gum to increase saliva which neutralises the acid. 8. Avoid bending down after a meal. Medications are usually very effective such as antacids including Gaviscon, ranitidine or omeprazole.

How can we get rid of heartburn? 

Reflux is normally a chronic condition. Lifestyle and dietary modifications as stated above and medication (see answer to remedies) are usually very effective in controlling the condition.