Holidays Can Be an Acid Test

By Jennifer Huget
Tuesday, November 4, 2008

The highly charged election season that (we hope) will finally be over when the polls close tonight has left a bad taste in many mouths.

Or maybe that bitterness is just stomach acid gurgling back up into your throat.

Chances are, you've experienced heartburn occasionally, maybe in bed after eating a large meal. Sometimes it feels like the onset of a heart attack or a burning sensation behind the breastbone. Or maybe a thickness at the back of your throat that makes swallowing uncomfortable. You might have popped some Tums and not given it another thought.

But for millions of us, the passage of caustic stomach acid up into the esophagus is a chronic pain in the throat. Acid reflux, which causes both occasional heartburn and ongoing gastroesophageal reflux disease (GERD), has become a major health concern as Americans grow fatter. Untreated, severe cases may lead to narrowing or ulceration of the esophagus or, very rarely, esophageal cancer.

Elaine Magee wants to help. A registered dietitian with a master's of public health in nutrition, she has just released a revised edition of "Tell Me What to Eat If I Have Acid Reflux" (New Page Books, $12.99).

Magee, who is married to a reflux sufferer, says more than 60 million Americans experience heartburn at least once a month. (And it's not just Americans who want her advice: The original edition of her book, released in 2001, has been reprinted in 10 languages, including Chinese and Polish.)

She offers a comprehensive overview of the medications available, from simple antacids such as Rolaids to H2 blockers (such as Pepcid and Zantac) and proton-pump inhibitors (such as Prilosec and Protonix). But her focus is really on food: what we should and shouldn't put in our mouths to keep heartburn at bay.

Her key recommendation? Eat less.

While thin people certainly suffer from acid reflux, overweight people are at far greater risk. Filling the stomach too full encourages acid to travel upward.

Reflux occurs when the sphincter muscle at the bottom of the esophagus doesn't close properly, allowing stomach contents to rise. But eating smaller meals, Magee notes, can curb the problem in the short term and lead to weight loss, which may relieve the symptoms altogether.

Magee also counsels those with acid reflux to quit smoking and to eat plenty of fiber to keep food moving through the digestive system. She recommends keeping a food journal (she provides one in the book) to record heartburn episodes. That can clarify which foods trigger discomfort and pinpoint times of day when you're most likely to be struck. That can help you learn to avoid those foods -- for many, they include tomato sauce, chocolate, coffee, peppermint and fatty or fried items -- and make lifestyle changes such as raising the head of your bed, which puts gravity to work against your rising stomach acid at night.

As for alcohol, its role is mixed. "A little is good," Magee says. "A lot is not better." She explains that while "a low dose can speed stomach emptying, drink too much and it's almost as if your stomach is confused and drunk," and your belly ends up emptying more slowly, setting the stage for reflux.

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