If you’ve been having repeated episodes of heartburn—or any other symptoms of acid reflux—you might try the following:
When the stomach is very full, there can be more reflux into the esophagus. If it fits into your schedule, you may want to try what is sometimes called “grazing”—eating small meals more frequently rather than three large meals daily.
People with acid reflux were once instructed to eliminate all but the blandest foods from their diets. But that’s no longer the case. “We’ve evolved from the days when you couldn’t eat anything,” Dr. Wolf says. But there are still some foods that are more likely than others to trigger reflux, including mint, fatty foods, spicy foods, tomatoes, onions, garlic, coffee, tea, chocolate, and alcohol. If you eat any of these foods regularly, you might try eliminating them to see if doing so controls your reflux, and then try adding them back one by one.
They make you burp, which sends acid into the esophagus. Drink flat water instead of sparkling water.
When you’re standing, or even sitting, gravity alone helps keeps acid in the stomach, where it belongs. Finish eating three hours before you go to bed. This means no naps after lunch, and no late suppers or midnight snacks.
Avoid vigorous exercise for a couple of hours after eating. An after-dinner stroll is fine, but a more strenuous workout, especially if it involves bending over, can send acid into your esophagus.
Ideally, your head should be 6 to 8 inches higher than your feet. You can achieve this by using “extra-tall” bed risers on the legs supporting the head of your bed. If your sleeping partner objects to this change, try using a foam wedge support for your upper body. Don’t try to create a wedge by stacking pillows. They won’t provide the uniform support you need.
Increased weight spreads the muscular structure that supports the lower esophageal sphincter, decreasing the pressure that holds the sphincter closed. This leads to reflux and heartburn.
Nicotine may relax the lower esophageal sphincter.
Some—including postmenopausal estrogen, tricyclic antidepressants, and anti-inflammatory painkillers—can relax the sphincter, while others—particularly bisphosphonates like alendronate (Fosamax), ibandronate (Boniva), or risedronate (Actonel), which are taken to increase bone density—can irritate the esophagus.
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