High-Risk Heartburn Groups

Heartburn and Statins – Do Statins Cause Acid Reflux?

There has been a lot of talk suggesting that statins (the popular class of cholesterol-lowering drugs) can be a cause of heartburn. It is listed on numerous websites as having the side effect of heartburn and this connection is also mentioned in several popular books on acid reflux. However, is there any evidence of this? Let’s find out!

Statins – What Are They?

The term statins simply refers to the class of medications that have become very popular around the world for their ability to reduce LDL cholesterol and inflammation in the body. The most popular statins include the brands Lipitor, Zycor, and Crestor (among others). Given the ubiquity of obesity, statins are among the most prescribed medications in the United States.

Statins and Heartburn – The Research

Despite the fact that statins are linked with heartburn anecdotally as well as listed on multiple third-party websites, the official NIH (National Institute of Health) page as well as the official site for Lipitor make no mention of acid reflux being a recognized side effect of statins. Now, this does not mean they aren’t recognized – it just is not documented.

I will say that of the listed side effects, other digestive issues such as upset stomach, constipation, or diarrhea are recognized as side effects of most statins (note that there are slight differences among each type of statin – but this is beyond the scope of this article). Additionally, unusual muscle function (cramping, involuntary contractions, fatigue) are also reported.

With that in mind, given that heartburn can be caused by irregular motility of the digestive tract, and that the usage of statins seems to cause irregular muscle activity, it would stand to reason that stains may indeed have acid reflux as a side effect.

Statins and Acid Reflux – What to Do

However, just because statins may have lead to heartburn does not mean that you should disregard your doctor’s advice if he (or she) prescribes them. Now, understand that I have very negative feelings about the chronic usage of prescription medication, but the facts are the facts: statins save lives.

Statins do not just make you more comfortable; there are dozens of very large studies which have reported that statins reduce not only cholesterol but also all-cause mortality (1, 2). There are many other studies that report the same thing: people who take statins just live longer.

The results surrounding statins are so good that some doctors have been even issuing them to those with low-risk for developing cardiac disease to help prevent cardiac disease from developing. It has become so wide spread that a recent Cochrane Review stated that while statins were beneficial, they did not recommend issuing them for low-risk patients (2).

The point is this – yes, statins may have side effects, but if you are a moderate or high-risk individual, they can save your life and help you live a lot longer. In regards to the development of acid reflux – you can talk to your doctor if you develop side effects, but personally I’d rather be alive with acid reflux than die prematurely without it. Interestingly though, a recent study reported that the use of statins was actually reported to reduce the risk of developing esophageal adenocarinoma (esophageal cancer) in those with Barrett’s Esophagus (a condition present in some with esophageal damage, particularly due to GERD) (3). Perhaps due to the anti-inflammatory properties of statins they can even reduce the damage done by acid reflux and be protective rather than destructive.

Statins and Acid Reflux – The Bottom Line

There are two important takeaways that you should get from this article. The first is that although statins may or may not cause heartburn, they do save lives and have been repeatedly shown to reduce all-cause mortality. The other thing to remember is that those who need cholesterol-lowering drugs and those who have acid reflux have a few common factors: obesity, smoking, and a poor diet.

Perhaps if you are on statin medications and are developing acid reflux, this may serve as a bit of a wake-up call. If you need to lose weight, quit smoking, or start following a smart acid reflux diet, those are things should be at the top of your priority list so that you can live a healthier and more satisfying life.

As always, everyone responds to medication differently. The decision to start or stop a medication should always be done under a doctor’s supervision. Statins do have some dangerous side effects, particularly related to liver and kidney dysfunction. Talk to your doctor about your medication if you have any concerns or side effects.

References

1. Baigent C., et al. Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170,000 participants in 26 randomised trials. Lancet. 2010 Nov 13;376(9753):1670-81.

2. Taylor F., et al. Statins for the primary prevention of cardiovascular disease. Cochrane Database Syst Rev. 2011 Jan 19;(1):CD004816.

3. Nguyen DM, Richardson P, El-Serag HB. Medications (NSAIDs, statins, proton pump inhibitors) and the risk of esophageal adenocarcinoma in patients with Barrett’s esophagus. Gastroenterology. 2010 Jun;138(7):2260-6.

Iodine Supplements and Heartburn

As early as 1982, researchers have been able to demonstrate a solid link between acid reflux and hypothyroidism (1). It is theorized that hypothyroidism may effect the motility of the esophagus and reduce lower-esophageal sphincter pressure (1).

It is fairly safe to say that hypothyroidism and heartburn are related. However, is there anything we can do about this? Of course – and you are about to find out what!

Iodine Supplementation – A Possible Heartburn Remedy?

One of the biggest contributing factors to hypothyroidism (and as such, thyroid-related acid reflux) is inadequate iodine intake.

In response to a few studies demonstrating that high iodine intake leads to possible cancer and hypothyroidism, Iodine has received a particularly bad reputation lately.

However, you should know that this study did confirm that high iodine intakes may cause cancer or lead to hypothyroidism, the “excessive” group excreted a median of 651 micrograms per liter of urine (2). While, this may not seem like a lot, consider this:

• The average human excretes 1.5 liters of urine a day.

• The recommended daily allowance for iodine intake is 150 micrograms.

So, in order to be excreting (sans what their body was actually using) over 1,000 micrograms a day, the average person in the excessive group in this study was easily consuming an average 5 times the recommended daily allowance for iodine for a length of time.

As a result, the average person in a modernized nation is going to rarely be consuming those levels of iodine. This is much more typical of an eastern diet which includes a lot of seaweed and kelp. These plants contain extremely high levels of natural iodine not approached by any other food on the planet!

Now that we have got that out of the way, another study of a similar population confirmed that unusually low levels of iodine intake are associated with thyroid disease (3). We knew this all along, but it is good to see some positive research since the “high iodine” study.

The Dark Side of Sea Salt

Iodine intake has always been quite naturally low in the western diet. In order to combat this issue, most salts in the USA have been iodized. Since salt is used ubiquitously in cooking, it was thought that this would significantly reduce iodine deficiencies (and indeed it did).

The problem is now sea salt has begun replacing normal salt on many tables. For some reason sea salt is thought as some sort of health food because its natural, but the truth is it lacks iodine which is far more essential of a nutrient than any mystery minerals which might be found in sea salt.

Unless the package specifically says iodized, your sea salt has no significant levels of iodine. You can buy iodized sea salt online, but I have not seen it in the typical grocery store.

With this in mind, consider adding iodized salt to your acid reflux diet. If you cannot add salt to your diet to due to restrictions (such as edema or high blood pressure), consider an iodine supplement. A very small supplement of just 100-150 micrograms (micro, not milli) should be fine. Be careful, because many iodine supplements are 600+ micrograms, which is unsafe unless done under a doctor’s supervision (as a doctor can collect and monitor bloodwork and urinalyses).

Important: Do not take an iodine supplement if you are taking medication already for hyperthyroidism (overactive thyroid). If you already eat a iodine-rich diet (i.e. eastern diet rich in seaweed or kelp) do not use an iodine supplement.

Other Ways to Help Hypothyroidism

In addition to adding iodine to the diet, another great way to help get your thyroid back on track is to lose weight. I know a lot of people say that the reason they are fat is hypothyroidism, but the truth is that in most people the situation is reversed.

A small minority of the population has thyroid problems due to genetics, cancer, radiation exposure, or other illness. A vast majority of the population is experiencing poor thyroid function due to obesity. Obesity negatively impacts every body system, and the thyroid is no difference from this.

When you consider this, it is not surprising that diagnoses of thyroid disorders have exploded over the last 15 years and obesity has exploded over the last 20 years. This is not a coincidence.

The good news is that both heartburn and thyroid disorders often become milder (and frequently reverse) when you lose weight. This allows you to tackle acid reflux from two fronts through weight loss.

Medication

Of course, many will elect to go on medication for hypothyroidism if diagnosed. This is entirely up to you and your doctor. Many people report great improvements to their quality of life after starting this medication.

If you are experiencing symptoms of hypothyroidism such as brittle nails, dry skin, cold hands and feet, mental fatigue, and possibly even acid reflux, you will want to see your doctor and get some bloodwork done.

Hypothyroidism, Iodized Salt, and Acid Reflux Conclusion

Given that low iodine intake is related to hypothyroidism and hypothyroidism is related to acid reflux, I do not think it is too far of a stretch to consider iodized salt and iodine supplements to be good heartburn home remedies. If you prefer the flavor of sea salt, consider getting iodized sea salt, which is readily available online.

As always, talk to your doctor if you have any health concerns or are experiencing heartburn symptoms two times a week or more. If you need to lose weight, just remember that weight loss is tied to both reduced acid reflux and improved thyroid function!

References

1. Eastwood GL, Braverman LE, White EM, Vander Salm TJ. Reversal of lower esophageal sphincter hypotension and esophageal aperistalsis after treatment for hypothyroidism. J Clin Gastroenterol. 1982 Aug;4(4):307-10.

2. Teng, W., et al. Effect of iodine intake on thyroid diseases in China. N Engl J Med. 2006 Jun 29;354(26):2783-93.

3. Yu, X., et al. A five-year follow-up study of goiter and thyroid nodules in three regions with different iodine intakes in China. J Endocrinol Invest. 2008 Mar;31(3):243-50.

Acid Reflux and Diabetes

Just recently in a very popular heartburn book, I read that diabetes was a major cause of acid reflux and that getting your blood sugar in check was a major step in controlling your acid reflux.

Up until that point in time, I had never come across any research or read any other reports that would indicate that this was true (or false), so I decided to look into whether or not there was any validity to this claim.

So are acid reflux and diabetes related? Additionally, do certain treatments have the side effect of acid reflux?

You are about to find out the answer to these questions as below I will be revealing what I found after digging in to the literature. I will start with laying out the research for both sides and then interpreting the validity of each study.

Support in Favor of a Positive Correlation Between Acid Reflux and Diabetes

The specific book I was reading referenced a study that looked at diabetic patients who used insulin therapy and those who did not. The researchers reported that those who used insulin therapy for their diabetes were more likely to GERD and esophageal damage from their reflux than those who did not use insulin therapy (1).

Additionally, I was able to find another study where researchers were able to demonstrate that the longer individuals were afflicted with diabetes, the likely they were to have GERD and other esophageal disorders (2).

Support Indicating No Relationship Between Heartburn and Diabetes

While the first two studies were interesting if nothing else, this is where the support for the link between diabetes and acid reflux ends.

By far the largest study I was able to find (looking at over 1,500 patients) reported that there was no difference in rates of acid reflux or instances of acid-related esophageal damage when comparing regular people with diabetes (3).

Another group of researchers reported they were unable to find any differences in GERD rates between different types of treatment protocols for diabetics, in direct opposition to study 1 (4).

Finally, one group of researchers even reported that those with the highest blood sugar levels (very poor glucose control) actually had much lower rates of acid reflux than those with slightly better glucose control (5).

Confounding Factors

There are a few confounding factors that should be made known about the particular pieces of research cited in this article. First off, the initial study reporting that people who use insulin as being much more likely to get heartburn was written in Russian; only the abstract (a brief summary) was available in English, which makes me curious as to how the author in the book I mentioned was able to interpret it (I am guessing they did not read the original piece).

The second study (in support of acid reflux and diabetes being linked) and fifth study (reporting that those with the highest blood sugar levels had less reflux) both used very small sample sizes, which could make their results be up to chance rather than reliable evidence.

The safest study is the third one referenced, which supports no difference between regular individuals and diabetics. This is simply because they had such a large sample size (over 1500 people) and adjusted for confounding factors and other risk factors.

Interpreting the Research – GERD and Diabetes

Based on what I have read of the research, right now there is simply no way you can say with complete certainty that diabetes or diabetic treatments are linked with acid reflux.

It is much more likely that the things which dispose individuals to type-2 diabetes (obesity and a high-carbohydrate diet) also dispose individuals to acid reflux. Obesity in particular is very strongly linked with acid reflux and diabetes.

Furthermore, another thing to consider is gastroparesis. With the translation of stomach paralysis, this may occur with nerve damage (particularly to the vagus nerve) and lead to acid reflux.

Patients with particularly severe cases of diabetes (particularly left untreated) may end up with vagus nerve damage and ultimately develop gastroparesis. This also helps explain the findings of study 1 and 2.

Study 1 was conducted in Russia; health care in Russia does not rank well on a world scale, which would make insulin-dependent diabetics more likely to develop gastroparesis.

Study 2 reported that longer-term diabetics often had worse acid reflux, which could be the result of nerve damage due to prolonged periods of elevated glucose levels.

Diabetes and Acid Reflux – Summary

According to our current set of research, well-managed diabetes is not likely to lead to acid reflux or heartburn. Obesity is one of the strongest risk factors for both diabetes and acid reflux, which is why the two may be correlated (but not necessarily directly related). Finally, prolonged periods of very poorly managed diabetes may result in gastroparesis, which can lead to acid reflux.

Individuals with diabetes and acid reflux should focus keeping their glucose levels at a healthy level and weight loss (should they be overweight or obese). An acid reflux diet should be secondary to managing glucose and weight loss.

References

1. Fedorchenko IuN, Korneeva NV. Influence of the insulin therapy on the course of gastroesophageal reflux disease with type 2 diabetes. Eksp Klin Gastroenterol. 2010;(11):35-9.

2. Kinekawa, F., et al. Esophageal function worsens with long duration of diabetes. J Gastroenterol. 2008;43(5):338-44

3. Holub JL, Silberg DG, Michaels LC, Williams JL, Morris CD, Eisen G. Acid-related upper endoscopy findings in patients with diabetes versus non-diabetic patients. Dig Dis Sci. 2010 Oct;55(10):2853-9.

4. Horikawa, A., et al. Prevalence of GORD (gastro-oesophageal reflux disease) in Type 2 diabetes and a comparison of clinical profiles between diabetic patients with and without GORD. Diabet Med. 2009 Mar;26(3):228-33.

5. Lauffer A, Forcelini CM, Ruas LO, Madalosso CA, Fornari F. Gastroesophageal Reflux Disease is Inversely Related with Glycemic Control in Morbidly Obese Patients. Obes Surg. 2011 Jul;21(7):864-70.

Milk and Heartburn – Is Milk A Good Acid Reflux Remedy?

In this article, we will be investigating the idea that milk can help relieve acid reflux. Milk is popularly recommended as one of the best heartburn remedies, but is this the truth or just an old wives’ tale?

The Chemistry of Milk and Heartburn

First, we need to look at any path of action that milk may be able to use in order to reduce heartburn. The first step is to look at exactly what is in milk itself.

Milk is actually a weak acid, with a standard pH of 6.7 (anything between 0-7 on the pH scale is considered an acid). However, since it is a weak acid, it acts as a buffer solution. A buffer solution is a solution that resists changes to its pH.

To clarify for those not versed in chemistry; hydrogen ions (H+) are what makes a solution acidic; the more H+, the more acidic a solution is. Buffer solutions (i.e. milk) are able to absorb H+ ions without any change in their pH, by storing them in a different chemical form.

As a result, when you mix milk and stomach acid, the resulting solution is less acidic than stomach acid. This occurs because milk absorbs some of the H+ ions that make stomach acid acidic.

In this way, milk acts much like antacids. Calcium carbonate, a popular antacid, acts as a buffer as well, absorbing H+ ions to resist changes in pH.

The Problem With Milk as a Heartburn Remedy

One major problem with milk is that some people are allergic to milk. There is some evidence, for example, that lactose intolerance (also known as lactose malabsorption) can lead to heartburn when drinking milk (1). While milk protein allergies are not as common as lactose intolerance, it is well-documented that milk may lead to reflux in this particular group (2).

Just because milk can act as a buffer solution does not mean we necessarily recommend it. Milk acts much in the same way as calcium carbonate does (calcium carbonate is the primary ingredient of nearly all over the counter antacids). While “natural”, milk is not necessarily superior to calcium carbonate given milk’s ingredients (lactose and casein are particularly troublesome for some people).

The real issue here is that we know antacids are not always effective at relieving heartburn, and milk acts just like an antacid. Antacids often leave people with a “sour stomach” feeling or only work temporarily.

Taking too many antacids (or drinking too much of any buffer solution such as milk) might temporarily change the pH of the stomach, causing pepsin to become deactivated (pepsin is an extremely important digestive enzyme that only works under acidic conditions). Anything which interrupts digestion may only make heartburn worse.

Milk as a Heartburn Remedy – The Bottom Line

The end result is that some people might get temporary relief from heartburn after drinking a glass of milk, but this is likely to be short-lived and no more effective than taking a simple antacid.

Overall, we feel that this drinking milk to stop heartburn is much less effective than other natural remedies such as chewing gum; the saliva produced by chewing gum can help blunt symptoms as well as improve digestion, whereas milk only blunts symptoms.

References

1. Minenna MF, Palieri A, Panella C, Ierardi E. Gastro-oesophageal reflux disease and lactose malabsorption: Casual comorbidity or neglected association? Dig Liver Dis. 2006 Jun; 38(6):437-8.

2. Caffarelli, C., et al. Cow’s milk protein allergy in children: a practical guide. Ital J Pediatr. 2010 Jan 15; 36:5.

Causes of Heartburn in Women

Heartburn and acid reflux are extremely common conditions found throughout the world. Below, you will discover what the causes of heartburn in women are and the one risk factor that causes nearly all women to get heartburn.

Causes of Heartburn in Women

In women, just like in men, heartburn is caused when the stomach’s contents leak out of the stomach and enter the esophagus.

Under normal conditions, the Lower Esophageal Sphincter (LES for short) will function to prevent this from happening. The LES is a band of smooth muscle that forms a ring shape over the exit to the stomach. Normally this band contracted tightly and allows food and drink to enter the stomach, but prevents it from leaving.

Heartburn occurs when this functionality breaks down. As a result, anything that interferes with the function of the LES can be a cause of heartburn.

Below, you will find a list of specific things which are known to interfere either directly (by relaxing the muscular contraction) or indirectly (by increasing the production of stomach acid, putting pressure on the LES, or another path of action) with the LES’ function of preventing heartburn.

Think of the stomach like a balloon and the LES like the knot keeping the air in; just a tiny opening in the LES can lead to heartburn, just like a microscopic hole may leak air in a balloon, so even a little too much pressure on the stomach or an interfering agent can lead to heartburn.

What Causes Heartburn in Women – An Exhaustive List

All of the items below are known heartburn causes in women:

Obesity – Visceral body fat (fat around the organs) increases the amount of pressure placed on the stomach and increases the risk of heartburn.

Overeating – Eating too much food in one sitting also puts pressure on the LES, causing further strain on this muscle.

Trigger foods – Certain foods, particularly spicy foods or foods that are hard to digest, may cause heartburn by forcing the LES to relax. See this list of foods that cause heartburn for a full list.

Pregnancy – Pregnant women are significantly more likely than all groups to get heartburn; this is thought to be due to the pressure the fetus places on the stomach, given that heartburn during pregnancy is extremely common in the third trimester and is fairly uncommon in the first.

Hiatal Hernia – Hiatal hernias occur when the stomach and esophagus move through a weakening in the diaphragm. People with hiatal hernias are much more likely to experience heartburn, and pregnancy is thought to be a risk factor for developing a hiatal hernia.

Caffeine – Caffeine can stimulate the production of stomach acid and is a cause of heartburn in women.

Nicotine – Nicotine, found in tobacco products, is thought to both stimulate the production of stomach acid and cause the LES to relax, making it one of the causes of heartburn in women.

Body Position – Laying down alone can cause heartburn in women if the LES is not functioning properly. Even if there is a small opening in the LES, gravity will often keep the stomach’s contents in place. It is only when we lay down that the stomach’s contents begin to leak and we experience heartburn. As a result, you can elevate the head of your bed by placing wooden blocks underneath the bed posts and significantly cut down on nighttime heartburn.

Stress – The link between stress and heartburn is well-established, though the exact mechanism for which stress can cause heartburn in women may vary from individual to individual.

What Causes Heartburn in Women Conclusion

As you can see, many of the causes of heartburn in women are the same for both genders. The only female-specific risk factor for heartburn is pregnancy.

Be sure to check out our simple yet effective home heartburn remedies for methods on managing your heartburn. If you run into heartburn twice a week or more, you should be sure to mention that to your doctor, as extended bouts of reflux may lead to esophageal damage.

Acid Reflux Symptoms in Women

Most women throughout the world will experience acid reflux throughout their lifetime. In this article, you will find out not only what the acid reflux symptoms in women are, but what factors specific to women may lead to heartburn.

Acid Reflux Symptoms in Women

The primary symptoms of acid reflux in women are:

• Heartburn. This is a burning sensation in the chest. The pain is centralized along the mid-line of the upper torso and typically is most intense directly behind the sternum (breastbone).

• Burping or spitting up of very small amounts of liquid or food, particularly with a sour or bitter taste.

• Coughing or sore throat – these acid reflux symptoms in women are only likely to occur if burping or spitting up of liquid is present; a sore throat indicates that the stomach’s acid and contents swelled very high and reached the top of the esophagus, indicating an intense episode of reflux.

• Difficulty swallowing or the feeling of something caught in the throat – this symptom does not typically develop off a single episode of reflux but rather repeated episodes, as typical in Gastroesophageal Reflux Disease (GERD). This could indicate irritation (inflammation) of the esophagus or throat. In more serious situations this may represent an esophageal stricture which is a narrowing of the esophagus due to inflammation or muscle spasm due to repeated exposure of esophageal tissue to stomach acid.

• Symptoms worsen when bending forward or lying down. This is one way to test for reflux; if you are experiencing heartburn-like symptoms, try lying down or bending forward and touching your toes. If your symptoms get worse and are relieved by standing, you are likely to be experiencing acid reflux.

Risk Factors For Women

For the most part, heartburn causes are the same (see linked article for a complete list). However, there is one distinct difference between men and women: pregnancy.

Acid reflux symptoms in women are extremely common during pregnancy; more women experience heartburn during pregnancy than those who do not, especially during the third trimester.

The most likely explanation for this is that the growing fetus puts pressure on the stomach and this pressure interferes with the stomach’s natural ability to keep food and liquid locked into the stomach.

Hiatal Hernia

However, the risk of acid reflux symptoms in women does not end with pregnancy. It is thought that pregnant women are more likely than the average person to develop hiatal hernias. A hiatal hernia typically involves the upper portion of the stomach and lower section of the esophagus moving above the level of the diaphragm.

Why is this important? Because this then places the Lower Esophageal Sphincter (the LES) above the diaphragm; the muscle group responsible for keeping the stomach’s contents in the stomach. The diaphragm then pinches the upper portion of the stomach.

This interferes with the function of the LES and can lead to heartburn. It is well-known that hiatal hernias can significantly increase your risk for acid reflux and GERD.

However, this is not to say that heartburn symptoms in women are more common than in men but rather that pregnant women or women have been pregnant are more likely to experience symptoms of acid reflux than women who are not (or have not been) pregnant.

Acid Reflux Symptoms in Women – The Bottom Line

The bottom line is that for the most part the symptoms of heartburn in women are the same as they are in men. Pregnant women are much more likely than non-pregnant women to experience these symptoms of acid reflux.

If you experience heartburn occasionally, I encourage you to try out these heartburn remedies. If you experience these symptoms of acid reflux two time per week per more, you will want to read this article on acid reflux treatment and discuss your symptoms with your doctor.

Hiatal Hernia Acid Reflux Relationship

A hiatal hernia is a fairly common medical condition which can result in regular acid reflux (i.e. GERD, regular heartburn). In this article, I will be revealing what exactly a hiatal hernia is and why it causes acid reflux so frequently.

Anatomy of a Hiatal Hernia

Under normal circumstances, the diaphragm is a muscular sheath which separates the chest cavity from the abdominal cavity. It sits upon the stomach and liver and divides the torso into its upper and lower half.

The diaphragm has a few “holes” in it which allow necessary structures like the esophagus (the tube connecting the mouth and stomach). Arteries and veins pass through the diaphragm as well.

However, under normal circumstances, the stomach does not pierce the diaphragm and is completely contained below this. A hiatal hernia occurs when a piece of the stomach manages to squeeze itself “above” the diaphragm, particularly navigating through the ‘hole’ where the esophagus pierces.

The end result is that the top portion of the stomach (at the gastro-esophageal junction) rests above the diaphragm and becomes “pinched” by the diaphragm. While rarely a life-threatening condition, this can (and frequently does) interfere with the function of the lower esophageal sphincter (LES), significantly increasing the risk for acid reflux.

Hiatal Hernia Acid Reflux Conundrum

The end result is that once you have a hiatal hernia, you are very likely to get heartburn. Since the LES cannot function optimally, having a hiatal hernia increases your susceptibility to the effects of pressure and body position on the stomach.

In order to reduce your run-ins with hiatal hernia acid reflux, it is recommended that you:

• Eat small meals instead of large meals to avoid significantly stretching the stomach

• Wear relaxed-fit pants so not pressure the abdomen

• Do not eat several hours before bed

• Raise the head of your bed by a few inches

• In the long term, look to lose weight (if you are overweight) and stop drinking alcohol and smoking. These can all increase your run-ins with hiatal hernia acid reflux.

By applying these simple tips, you can significantly reduce your run-ins with hiatal hernia acid reflux. If you still get reflux even after reducing meal size, we recommend trying these heartburn remedies.

Medical Treatment Options

If these lifestyle changes are not enough to stop heartburn, sometimes medication may be prescribed by your doctor. The most commonly used medication to help reduce hiatal hernia acid reflux is omeprazole, which is a proton pump inhibitor and available over the counter.

It is important to remember that hiatal hernias do not go away on their own nor are they “cured” by medication. Medication can help manage the symptoms if lifestyle changes are inadequate. Most people should experience significant relief simply by reducing meal size and losing weight.

The only way to repair a hiatal hernia is via surgery, however this is typically reserved for the most serious cases. Even the most advanced laparacopic surgery can result several days in the hospital and two weeks to a month out of work (depending on age).

Heartburn During Pregnancy

Getting heartburn in pregnancy is an unpleasant but common experience. Pregnant women are much more likely to get heartburn, especially in later trimesters than women who are not pregnant.

Cause of Heartburn in Pregnancy

The primary reason why heartburn during pregnancy exists is due to the actual physical mechanics of being pregnant. Physical pressure on the stomach significantly increases the risk of heartburn. This is why avoiding tight pants and belts is recommended for all people with heartburn: the pressure on the stomach can create heartburn or make it worse.

However, in pregnancy, the pressure of carrying a baby on the stomach (the actual organ) can create heartburn. The closer the baby is to delivery, the larger the baby gets, and the more pressure it applies to the stomach. As the baby compresses the stomach, heartburn can ensue.

Unfortunately, until delivery, your susceptibility of heartburn is very high. However, there are a few things you can do to help reduce the risk of getting heartburn during pregnant.

How to Stop Pregnancy Heartburn

One of the easiest ways to stop heartburn in pregnancy is by using our top two heartburn remedies: chewing gum and vinegar.

Try chewing gum throughout the day, especially after eating, to help reduce pregnancy heartburn. This helps produce saliva, aids digestion, and creates a pH buffer in the esophagus (see the heartburn remedies homepage for studies supporting this as well as how this works).

Note: Avoid peppermint-flavored gum and stick to something more mild, as many people get heartburn from peppermint!

Additionally, try taking a spoonful of vinegar (actual liquid vinegar, not capsules) when you experience heartburn during pregnancy. This can be a powerful home remedy and many people report great results with just a teaspoon of vinegar.

Reduce Pregnancy Heartburn Risk Factors

While these simple remedies can help stop heartburn in pregnancy, there are a few simple steps you can take to avoid getting heartburn in the first place:

• Eat small, frequent meals. The pressure of a very full stomach that is already being compressed by a baby can frequently lead to heartburn.

• Avoid laying down right after eating. Try to avoid eating 2-3 hours before bed as laying down after eating frequently leads to heartburn during pregnancy.

• Wear loose-fitting clothes. While it may not be fashionable, avoid tight pants. Combined with the pressure of carrying a baby, this is a sure way to get heartburn.

• Raise the head of your bed by 6 inches so you are sleeping on a slight incline. This will allow gravity to help keep down what belongs in the stomach.

Heartburn Medications and Pregnancy

There have been some questions lately about the safety of medications used for treating heartburn during pregnancy. In particular, proton-pump inhibitors are a fairly new class of medications. The oldest, omprazole, is available over the counter.

A recent cohort study tracking nearly a million children reported that there was no significant risk factors associated with using proton pump inhibitors during pregnancy (1).

However, I believe that it is still too early to call these drugs 100% safe to use and would rather err on the side of safety for the future child. We still do not know what if these children will express any abnormalities 10 years from now, nor is a single study, no matter how large, 100% conclusive about the safety of a certain medication.

Heartburn in Pregnancy Wrap-up

By following these preventative strategies and using our top two heartburn remedies, you can significantly reduce the severity and frequency of heartburn in pregnancy.

References

1. Pasternak B, Hviid A. Use of proton-pump inhibitors in early pregnancy and the risk of birth defects. N Engl J Med. 2010 Nov 25;363(22):2114-23.