It is a burning pain behind the breastbone, sometimes accompanied by watery acid coming back into the mouth. The reflux of acid from the stomach into the gullet is usually prevented by a valve at the junction of the two. This valve can become faulty in several medical conditions, or excessive amounts of acid may be produced by the stomach. Smoking reduces the effectiveness of the valve and, like alcohol, increases the amount of stomach acid produced.
What causes it?
• Hiatus hernia-a condition in which the top end of the stomach ruptures through the diaphragm into the chest.
• Heavy meals before retiring.
• Lying flat in bed.
• Smoking.
• Alcohol.
• Being overweight.
• Tight, constrictive clothing.
• Eating too heartily.
• Stress.
• Pregnancy.
Prevention
• Hiatus hernia is common in obese women, and slimming generally helps cure the condition. Prevention of hiatus hernia therefore includes keeping slim. Hiatus hernia is also thought to be caused by excessive straining to pass hard, sticky motions caused by eating highly refined and low-fibre foods. Probably the best preventive for hiatus hernia is a high-fibre diet with plenty of fruit and vegetables, whole meal-flour products and fluid. This keeps the motions soft and means that the individual does not have to strain to pass stools. When straining at stool the pressure inside the abdominal cavity rises dramatically and forces the top end of the stomach to rupture into the chest.
• A large meal before retiring means that the stomach is full and triggered to produce a large amount of acid. The full stomach will also force food up the lower end of the gullet if there is any weakness of the valve there. The acid will produce pain because it will come into contact with gullet lining that is sensitive to acid.
• Raising the head of the bed on books or a couple of bricks and keeping several pillows behind you is a good way of keeping the upper part of your body upright. This in itself can help cure and prevent heartburn.
• Cut down on or stop smoking.
• Cut down or stop drinking alcohol.
• Reduce your weight-this alone can work wonders.
• Don’t wear tight belts, corsets or even tight skirts or trousers. This can have the effect of forcing the abdominal contents upwards and making heartburn worse.
• Eating too heartily can produce indigestion and an over-production of gastric acid. Chew food well before swallowing and eat several small meals rather than having a smaller number of big blow-outs.
• Stress is a powerful producer of acid in the stomach. If acid travels from the stomach into the first part of the intestine it can cause a duodenal ulcer but if it flows into the gullet it can cause a lot of pain and a condition known as reflux oesophagitis. This can be prevented by taking medications that stop acid production in the first place (available on prescription from your doctor) or you can take antacids or stomach powder; to mop up the acid. Milk does not help as it actually increases stomach-acid production after a while. The best preventive is to sort out the causes of stress in your life and learn to relax.
• Pregnancy causes heartburn because the greatly enlarged uterus forces the abdominal contents upwards and encourages the reflux of gastric acid into the lower end of the gullet. The best preventives for this are: to sleep upright in bed at night; to adopt love-making positions that keep the woman upright; and to take antacids and frequent, small meals.
• Stooping can usually be avoided. Sit down to put on shoes, etc. Kneel down to pick things up. In short, avoid bending double for any reason.
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