Foods
Heroes
- Starchy foods. Rice, couscous, potatoes and crackers are a great place to start if you’ve been struggling with heartburn symptoms.
- Legumes. Beans and lentils are also good options.
- Other veggies. Turn to those with lower acidity. A neutral pH, around a pH of 6, is good—it’s neither strongly acidic nor alkaline. Neutral foods include kale, yellow squash, asparagus, and corn.
- Safe fruits. Acidic fruits like oranges and pineapples are bad for heartburn. The winners in the fruit category are cantaloupe, dates, watermelon, and honeydew melon.
- Poultry. Chicken and roast turkey both have a low acidity and are fairly lean, so those are good options.
- Seafood. Most freshwater fish, shrimp, salmon and herring have low acidity with a high pH (higher than 6).
Villains
While there may be many food villains out there, folks with severe heartburn symptoms tend to have heartburn because they are more likely to eat or drink things on this list. Especially for these people, limiting these foods has been shown to improve symptoms.
- Fried foods. Oil can make heartburn symptoms worse and foods drenched in oil like french fries, fried chicken or fish, and doughnuts are no exception.
- Peppermint. Peppermint in any form, shape, or size is a known cause of heartburn.
- Chocolate. Chocolate—specifically dark chocolate more than milk chocolate—can cause stomach acid to rise up into the esophagus, causing acid reflux and heartburn.
- Tomatoes. It’s not a 100% “no” here. Tomato paste, tomato juice, and canned tomatoes are more acidic than whole, raw tomatoes, so it’s possible that some forms of tomato may not trigger acid reflux for you.
- Ketchup and mustard. Most folks know of ketchup’s relationship to heartburn because of the tomatoes, but mustard is also makes symptoms worse.
Drinks
Heroes
- Dairy. Winners here are milk, eggs, and Swiss cheese. Remember, milk has a “neutral” pH, so it’s just as acidic as it is alkaline.
- What you should know about alcohol. If you are going to drink alcohol, know these tidbits:
- Wine. White wine is more acidic than red wine, so it may cause more heartburn.
- Beer. Beer is very acidic, and it’s carbonated. Those two things are bad for heartburn. But, compared to other alcohol beverages, beer has a relatively lower alcohol content—and that’s good in the world of heartburn. There is evidence that people who drink liquor have more heartburn than beer drinkers.
- Hard alcohol. Darker alcoholic drinks contain more naturally occurring compounds called congeners, which can increase stomach irritation and heartburn symptoms. Clear alcohols like vodka and gin contain fewer congeners than darker drinks like brandy, whisky, and rum. Just sayin.’
Villains
- Alcohol, take two. Like I mentioned, alcohol content isn’t good for heartburn. Alcohol causes heartburn symptoms in four ways: by keeping acidic content in the stomach longer, by stimulating the stomach to make more acid, by impairing the esophagus from keeping food down, and by making it easier for acid to rise up into the esophagus from the stomach. Whew! When it comes to alcohol, watch out for three things: how much you drink, carbonation, and alcohol content (how strong the drink is).
- Soft drinks. Carbonation causes the esophagus to become more acidic. Whether caffeinated or caffeine-free, it doesn’t matter. Carbonated drinks and sodas make nighttime heartburn symptoms much more likely.
- Carbonated water. Surprise! Carbonated water is just as bad as coke. Experiments in healthy individuals have shown that cola and carbonated water both allow food to return to the esophagus from the stomach to the same extent.
- Coffee. Whether decaf or regular coffee, coffee is a heartburn trigger. Why? Coffee is acidic, with a low pH of 4.
Medications
Heroes
- H2 blockers. H2 blockers (also known as histamine-2 antagonists) are a class medications that decrease stomach acid and include popular drugs like famotidine (Pepcid), ranitidine (Zantac), and cimetidine (Tagamet). You can start with these for heartburn relief. Once your heartburn improves, stop the medication. Almost all H2 blockers don’t work well after 2 – 6 weeks because the stomach adapts, and they become much less effective.
- Proton-pump inhibitors, when H2 blockers don’t help. If, after a couple weeks of taking H2 blockers, your heartburn is still there, try taking a proton-pump inhibitor (PPI) medication once daily. These include omeprazole (Prilosec), pantoprazole (Protonix), and esomeprazole (Nexium), all now available in prescription and over-the-counter strengths. If a PPI gets your heartburn symptoms under control, continue taking it for 8 weeks. Otherwise, this is when you’ll come see us, your primary care doctors.
Villains
- NSAIDS and aspirin. NSAIDs like ibuprofen (Advil, Motrin) and naproxen (Aleve), as well as aspirin, are very well-known triggers of heartburn. People tend to forget this, thinking these drugs are harmless as they are available over the counter.
- Other medications. Doxycycline, medications for osteoporosis, and other common drugs may also cause heartburn as a side effect. A list of stand-out offenders is covered in detail in this blog post here.
Hope this helps.
Dr O.
Source: Read Full Article