Who hasn’t overindulged in a meal and paid the price later? Whether the food faux pas was a celebratory hot fudge sundae, a third chili dog at the ballpark or that burrito hastily eaten behind the wheel, the outcome is nauseatingly familiar a sour taste at the back of the throat, a burning sensation in the middle of the chest.
Heartburn is a familiar foe. Roughly 50 percent of Americans feel the heat at least once a month; 20 percent suffer from symptoms two or three times a week and have chronic heartburn or GERD (short for gastroesophageal reflux disease). And those numbers are rising on the tide of obesity, which is a major contributing factor to the malady.
In fact, heartburn is such a universal sensation, says Elizabeth Lipski, PhD, clinical nutritionist and author of Digestive Wellness: Strengthen the Immune System and Prevent Disease Through Healthy Digestion (McGraw-Hill, 2011), that many have come to accept the associated discomfort as normal. “People think ‘this is just how my body works,’” she says.
The pharmaceutical industry is happy to lend a hand, of course. Prescription drugs that target heartburn are one of the top-10-grossing classes of drugs on the market in the United States.
In 2011, according to the IMS Institute for Healthcare Informatics, Americans spent more than $10 billion on heartburn medications, namely H2 blockers and proton pump inhibitors (PPIs).
Chronic heartburn can lead to sleep loss, fatigue, nutritional deficits and disruptions of healthy intestinal flora. And while heartburn medications do a good job of temporarily relieving symptoms, long-term reliance on them (especially big-gun H2 blockers like Pepcid AC) can undermine your health over time.
Gastroenterologist Jorge Rodriguez, MD, has firsthand experience with heartburn, and with how to heal it. Overweight for most of his adult life, Rodriguez, author of The Acid Reflux Solution: A Cookbook and Lifestyle Guide for Healing Heartburn Naturally (Ten Speed Press, 2012), had excruciating heartburn after nearly every meal. “I thought the pain was simply the price I had to pay to eat,” he says. “Happily, I was wrong.”
Think of heartburn as faulty plumbing. The mouth and stomach are connected by a pipe, called the esophagus, and after you swallow, food slides down the pipe before it plunks into the stomach.
On splashdown, an O-ring of muscle at the base of the esophagus (called the lower esophageal sphincter or LES) cinches tight to keep the mixture of food and gastric juices from moving back up the pipe. If the sphincter doesn’t seal correctly, the stomach’s contents slosh up into the esophagus and irritate the lining.
Stomach acid is strong stuff. “It’s meant to burn through flesh,” says Rodriguez. “After all, that’s what a hamburger isť — flesh.” A drop or two of the stuff won’t burn a hole in your gullet, but when you have GERD it’s like continuous waves of acid lapping against the delicate lining of the esophagus. Eventually, that acid will erode the shoreline, making matters worse.
The most common sign of heartburn is a painful sensation in the stomach, throat or chest. Other signals include belching, persistent sore throat and a sour taste in the back of the mouth caused by food regurgitating.
Up to 50 percent of people with GERD have some damage to the lining of their esophagus. As many as 15 percent of people will develop Barrett’s esophagus, a lesion at the base of the esophagus that ups the odds of esophageal cancer.