Summer Foods: Don't Feel the Heartburn

1. Heartburn Slideshow: Foods to Eat, Foods to Avoid
2. Digestive Myths Slideshow: Common Misconceptions
3. GERD Quiz: Test Your Digestive Diseases IQ

Just because it's hot outside doesn't mean you have to feel the heat of heartburn when enjoying foods of the season.

By Star Lawrence
WebMD Weight Loss Clinic - Feature

Reviewed By Michael W. Smith, MD

Ever chow down at a family picnic, come home, shower, lie down, and feel a burning pain in your chest and acid crawling up your throat like a red-hot snake? These are symptoms of the ever-popular heartburn!

Rodger A. Liddle, MD, professor of medicine and gastroenterologist at Duke University, tells WebMD that many favorite summer foods -- such as tomatoes, barbeque, cocktails or beer, and citrus -- can make acid reflux worse, although they don't "cause" this much-dreaded condition.

More than 50 million adults experience heartburn more than two days a week. Half of those get it daily.

Although it has become the staple of commercials and sitcoms, heartburn can limit activities and productivity. And to those lying there in the dark or burping through a long afternoon meeting, heartburn is far from a joking matter. In its most severe forms it can eat away at the esophagus, which can lead to esophageal cancer.

Better to recognize heartburn and avoid or treat it.

Causes of Heartburn

To digest food, the stomach is flooded with acid. Between the stomach and the esophagus is a sphincter muscle that lets the food get to the stomach but then closes to keep the stomach acid from flowing back up the throat. If this muscle becomes loose or doesn't work properly, the stomach contents can backflow into the esophagus, making it burn.

Or you can eat foods that are acidic themselves that can irritate tiny areas of irritation you already have on the walls of your esophagus.

The body tries to counter this not only with the sphincter, explains Liddle, but with saliva, which is alkaline. But sometimes these mechanisms are overcome by circumstance. Some factors that make heartburn more likely:

• Being overweight
• Smoking
• Lying down after eating
• Bending over after eating
• Pregnancy
• Certain medications
• Stress
• Wearing tight clothing
• Eating trigger foods

Summer Foods That Trigger Heartburn

Elaine Magee, MPH, RD, author of Tell Me What to Eat If I Have Acid Reflux and of a new DVD titled The Heartburn-Friendly Kitchen, tells WebMD that trigger foods vary from person to person.

"People tend to know," Liddle says. "They will say, 'I get heartburn every time I eat pizza.'"

Some real culprits that turn up time and time again are:

• Fatty meats and deep-fried foods (they stay in the stomach longer, giving acid more of a chance to wander)
• Citrus
• Chocolate
• Peppermint
• Excessive alcohol consumption (especially red wine)
• Tomatoes (salsa, catsup)
• Colas and coffee (caffeine and carbonation are both suspect)
• Orange juice
• Peppers
• Garlic and onions

Some of these weaken the hold of the sphincter and some scratch at irritation that is already there.

Other foods can bloat your stomach and force the acid back up your throat. These include carbonated beverages.

A good rule of thumb is not to eat greasy meals and foods that are already chockfull of acid.

So What Can You Eat for a Heartburn-Free Summer?

The key to enjoying summer foods is to know what agrees with you, Magee says.

• If grease bothers you, stick with grilled or raw foods.
• Instead of tomatoes, load up your salads with carrots, beans, jicama, or other milder veggies.
• If chocolate is a trigger, eat a few Kisses instead of a double helping of Death by Chocolate cake.
• Burgers are OK, Magee says, but get the leanest cuts and dress with guacamole or something less acidic than catsup.
• If carbonated drinks lead to late-night torture, stick with iced tea.
• If Margaritas and you don't get along, drink less or switch to a virgin strawberry type.
• Watermelon can be acid-producing. Consign it to a mixed fruit salad only.
• Eat smaller portions. Your stomach detects large amounts and pumps out more acid.

Other Tips for Preventing Heartburn

Both Liddle and Magee agree that when you eat and how much have a real effect on heartburn.

If you're prone to heartburn, Magee recommends eating three to four hours before bedtime. "Often people won't eat all day while they are running around in the heat," she says. Then when they eat at night, they eat too much and then go to bed. This makes stomach contents more likely to splash up."

If you are taking aspirin, pain meds, antibiotics, or iron, be extra cautious. These can set off heartburn.

Other ways to help drench your heartburn include:

• Exercise as usual, but don't eat before, during, or just after.
• Lose weight if you are overweight.
• Stop smoking (it not only stimulates acid production, but loosens the valve that protects your throat and can also reduce saliva production).
• Elevate your bed with wedges.
• Take over-the-counter medication. If you find you need something more than twice a week check with your doctor. You may need a prescription.
• Relax! The stress doesn't cause the heartburn, but it can cause you to gobble trigger foods.

If you get heartburn daily, despite lifestyle and eating changes, Liddle suggests consulting a physician.

Published June 20, 2005.

SOURCES: Rodger A. Liddle, MD, professor of medicine and gastroenterologist, Duke University. Elaine Magee, MPH, RD, author, Tell Me What to Eat If I Have Acid Reflux, and the DVD The Heartburn-Friendly Kitchen.

©2005 WebMD Inc. All rights reserved.