Role of diet in Heartburn

Acid reflux and gastroesophageal reflux disease (GERD) are conditions in which acid backflows from the stomach into the esophagus. This may result in heartburn and other symptoms. A weakening or injury to the lower esophageal sphincter (LES) — the valve between your stomach and esophagus — is one cause of GERD and acid reflux. Normally, the LES shuts to prevent food from traveling from your stomach into your esophagus. It does not seal correctly in GERD, allowing acid to seep back into the esophagus. The things you consume can influence how much acid your stomach generates and how the LES works.

Symptoms of heartburn

If your heartburn is caused by acid reflux, you may experience:

• Burping.
• A bitter aftertaste in the tongue.
• Nausea.
• Food regurgitation.

Other unusual acid reflux symptoms include:

• Bloating and fullness in the stomach.
• Hiccups.
• Cough that persists.
• Asthma is becoming worse.
• Throat ache.
• Laryngitis.
• Difficulty swallowing or the sensation of a lump in your throat.
• Angina-like chest discomfort (non-cardiac chest pain).

Is acid reflux usually the cause of heartburn?

Heartburn is often caused by an esophageal disease, with acid reflux being the most common cause. However, there are a few additional situations that might give you a similar experience:

Ulcers in the esophagus:

• Ulcers are lesions produced by erosion of the GI tract lining. 
• They generate a distinct searing discomfort. 
• Ulcers in the esophagus are far less prevalent than those in the stomach or intestine. 
• When they do develop, they are mainly caused by acid reflux. However, reflux is not the only probable reason. 
• Ulcers can also be caused by overuse of NSAIDs such as aspirin and ibuprofen.

Esophagitis: 

• A burning feeling in your esophagus may be caused by severe inflammation. 
• GERD, viruses, fungal infections, and certain drugs are all potential causes. 
• Heartburn can also be caused by an allergic disorder of the esophagus (eosinophilic esophagitis).

Hypersensitivity to functional heartburn/reflux:

• Functional gastrointestinal diseases are problems with the gut-brain connection, which is how your neural system transmits feelings from your digestive system to your brain. 
• Functional heartburn has the same symptoms as conventional heartburn, but there is no evidence of acid reflux, erosion, or inflammation. 
• Non-acid reflux causes reflux hypersensitivity. 
• Overactive nerves (visceral hypersensitivity) might add to the burning sensation.

Dietary Modifications to relieve heartburn 

Eating well for GERD does not have to include avoiding all of your favorite meals. Making a few modest changes to your existing diet is frequently sufficient. While there is no established “GERD diet,” the items listed below may help you manage or prevent symptoms.

Fruits and vegetables:

• While you should avoid citrus fruits and drinks like oranges and lemons, you can eat a variety of non-citrus fruits including bananas, melons, apples, and pears.
  
• Choose from a broad range of veggies. Sauces or toppings heavy in fat or other irritants, such as tomatoes or onions, should be avoided or reduced.

Lean protein

• Eggs are high in lean protein. These contain a lot of protein. If eggs bother you, stick to the whites and avoid the higher-fat yolks, which are more likely to trigger symptoms.
• Meat that is lean. High-fat meals and fried foods lower LES pressure and delay stomach emptying, increasing the risk of reflux. Choose lean cuts of meat that have been grilled, poached, broiled, or baked.

Carbohydrates 

• Oatmeal, full-grain bread, rice, and couscous are all options. All of them are excellent sources of complex carbohydrates. 
• Whole grains and brown rice are high in fiber.
• Root veggies such as potatoes are excellent sources of healthful carbohydrates and digestible fiber, but avoid adding onion and garlic during cooking because these are typical irritants.

Fats

• Fat is a nutrient that is heavy in calories yet important in your diet. All lipids are not created equal. 
• Avoid or limit saturated fats (typically found in meat and dairy) and trans fats (found in processed foods, margarines, and shortenings). 
• Replace them with unsaturated fats from vegetables or seafood in moderation. 

Here are a couple of such examples:

• Monounsaturated Fats: Olive, sesame, canola, and sunflower oils are examples, as are avocados, peanuts, and peanut butter, and a variety of nuts and seeds.
• Polyunsaturated fatty acids: Oils such as safflower, soybean, maize, flaxseed, and walnut are examples, as are soybeans and tofu, as well as fatty fish such as salmon and trout.

Foods to avoid to relieve heartburn

Certain meals and drinks can aggravate GERD symptoms such as heartburn and a foul taste from regurgitation.

People with GERD are generally recommended to avoid the following foods:

• Alcohol
• Caffeine
• Beverages with carbonation
• Chocolate
• Tomatoes and meals containing tomatoes
• Garlic
• Mint Onions
• Foods that are spicy
• Fattening foods
• Foods that have been fried 

Some of these things, such as fatty meals, chocolate, peppermint, and alcohol, are known to aggravate GERD symptoms by relaxing the lower esophageal sphincter (LES), the muscular ring that divides your stomach from your esophagus. This permits the stomach’s contents to enter the esophagus, resulting in heartburn.

• Other foods, such as tomatoes and citrus fruits, are thought to worsen symptoms by raising stomach acidity. They can also irritate the injured esophageal lining.
• Soda is a particularly hazardous beverage for persons with GERD since it is carbonated and frequently includes caffeine.
• Chocolate may be one of the worst foods for persons with GERD due to its high fat and caffeine content.
• High-fat dairy products, as well as fatty cuts of meat and processed meats like hot dogs and luncheon meat, are among the most hazardous fatty foods. 

Individual foods will elicit various reactions in different people. Pay attention to your nutrition, and if a meal or beverage causes heartburn, avoid it.

Foods That Aid in the Prevention of Acid Reflux

The good news is that there are several foods that can help avoid acid reflux itself. Stock your pantry with goods from the following three categories:

Foods high in fiber

Fibrous meals help you feel full, which reduces your chances of overeating, which may lead to heartburn. So, fill up on fiber-rich meals like these:

• Oatmeal, couscous, and brown rice are examples of whole grains.
• Sweet potatoes, carrots, and beets are examples of root vegetables.
• Asparagus, broccoli, and green beans are examples of green veggies.

Foods with an alkaline pH

• Foods fall someplace on the pH scale (a measure of acidity). 
• Low-pH foods are acidic and more prone to induce reflux. 

Higher pH values are alkaline and can help balance severe stomach acid. Foods that are alkaline include:

• Bananas 
• Melons
• Cauliflower
• fennel seeds,
• Watermelon
• Meals like Soups made with celery, cucumber, lettuce, and watermelon broth
• Herbal tea 

Home Remedies for Heartburn

Antacids, over-the-counter drugs that neutralize stomach acid, are often used by those suffering from heartburn. However, certain meals may provide relief from symptoms. Consider the following options:

Milk

• Milk’s fat content might cause acid reflux. Nonfat milk, on the other hand, can serve as a temporary buffer between the stomach lining and acidic stomach contents, providing instant alleviation of heartburn symptoms.
• Low-fat yogurt provides the same calming properties as well as a healthy dosage of probiotics (friendly bacteria that aid digestion).

Ginger

• Because of its therapeutic characteristics, ginger is one of the finest digestive aides. 
• It has an alkaline pH and is anti-inflammatory, therefore it soothes gastric inflammation. When you sense heartburn coming on, try sipping ginger tea.

Apple cider vinegar

• While there is little study to indicate that drinking apple cider vinegar helps with acid reflux, many individuals swear by it. 
• However, you should never consume it in its whole since it contains a powerful acid that might irritate the esophagus. Instead, dilute it with warm water and drink it with meals.

Water with lemon

• Although lemon juice is very acidic, a tiny amount of lemon juice combined with warm water and honey has an alkalizing effect that neutralizes stomach acid. 
• Honey also contains natural antioxidants, which protect cell health.

Other tips to reduce heartburn

• Chew some gum: Chewing gum (not spearmint or peppermint, which can relax the LES) promotes saliva production and lowers acid levels in the esophagus.
• Stay away from alcohol: Alcohol is a recognized irritant that can weaken the LES and cause symptoms of reflux. While some people’s symptoms may worsen after only one drink, others may manage moderate quantities. Experiment to find out what works best for you.
• Maintain proper posture both during and after meals: It’s best to sit up when eating and avoid sitting down for at least two hours thereafter. Standing up and walking about after eating helps to guide stomach secretions in the appropriate way.
• Avoid eating right before going to bed: Digestion raises the level of gastric acid in the stomach. When you lie down, the LES’s capacity to keep stomach contents from going up the esophagus reduces. Lots of stomach acid combined with a reclining position is a formula for reflux. Timing varies from person to person, but eating a substantial meal less than three or four hours before bed is not recommended for GERD patients.

Identifying your triggers

Acid reflux and GERD are frequently accompanied by heartburn. After eating a big meal or certain meals, you may get a burning feeling in your stomach or chest.

Other signs and symptoms include:

• Sore throat
• Bloating
• Burping
• Hiccups 
• swallowing difficulties
• a lump in the throat
• Vomiting
• Regurgitation

There is no single diet that may avoid all GERD symptoms, as dietary triggers range from person to person.

Keep a meal journal and track the following to find your own triggers:

• what meals you consume
• what time do you eat
• what symptoms you are experiencing
• Keep the record for at least a week, and much longer if your diet changes. You may use the diary to discover particular meals and beverages that cause GERD.

A doctor or nutritionist may give you more specific advice on what to eat and avoid, as well as assist you in developing a plan.

Medications for heartburn 

Heartburn medications include:

Antacids

• Antacids (such as Tums® and Rolaids®) neutralize stomach acid so that it does not corrode your esophagus when reflux occurs. 
• They frequently include substances that may help with other ailments as well. Simethicone, for example, can aid with gas, while magnesium can help with moderate constipation. 
• Antacids are useful for occasional heartburn, but they might have negative effects if used too frequently.

Alginates

• Alginates are sugars that occur naturally in seaweed. 
• They work by floating on top of the acid, forming a physical barrier between the acid and your esophagus. 
• If you are unable to take antacids owing to another problem, you can obtain alginates on their own. 
• You can also acquire alginates-containing antacids to boost their effectiveness.

Histamine receptor antagonists

• These lower stomach acid by inhibiting the chemical messenger that signals your body to create it (histamines). 
• Some H2 blockers are accessible over the counter, while others require a prescription. 
• They can be used more regularly than antacids, but they don’t always help in the long run. They may become ineffective if your body adjusts to them.

Proton pump inhibitors

• These are more potent acid blockers that help stimulate tissue repair. 
• If your heartburn is moderate to severe or you have symptoms of tissue damage in your esophagus, your provider may prescribe them as first-line therapy. 
• They have a 90% success rate in controlling acid reflux. They are the only drug that can help repair esophageal ulcers.

Additional heartburn remedies may include:

• Antibiotics or antivirals are used to treat infections.
• To treat the inflammation, use topical steroids or dupilumab.
• Neuromodulators at low doses and complementary therapy for functional heartburn.
• If your heartburn is caused by a hiatal hernia, you may need hernia repair surgery.

Takeaway

Eating well for GERD does not have to include avoiding all of your favorite meals. Making a few easy changes to your current diet is frequently enough to help alleviate the symptoms of GERD. The objective is to develop a diet that includes a wide range of fruits and vegetables, lean protein sources, complex carbs, and healthy fats.