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Caron Milham
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Caron Milham is an accredited practising dietitian with 25 years experience and the director of Caron Milham & Associates. She offers personalised, individual, professional counselling for all diet and nutrition concerns including weight loss, diabetes, heart and digestive health, and her company has provided dietary services to the South Australia Department of Health.
Caron has contributed articles on nutrition to a range of magazines and appeared regularly on Today Tonight. She has also written two books. The Australian Healthy Shopping Guide lists 2,000 of the healthier options from 48 food categories available in the supermarket aisles, showing which products are lower in sugar, fat, kilojoules and salt and higher in fibre and nutrients. The Australian Healthy Cooking Guide shows ways to turn healthy shopping into healthy cooking. You can visit her website at www.healthy-guide.com
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Bedtime burning and indigestion
A burning throat, bitter taste in your mouth, discomfort in your upper chest and indigestion can be a sleeper’s worst nightmare. Welcome to the world of reflux and heartburn.
Heartburn is another name for gastroeosphageal reflux disease (GERD). Gastroeosphageal reflux (GER) is more common than GERD and is the less serious form of this condition. Sometimes GER is also referred to as acid reflux or acid regurgitation.
GER occurs when the muscle at the bottom of your esophagus (the tube that carries food from your mouth to your stomach) opens spontaneously, or does not close properly. This results in regurgitated food and digestive bile and acid from your stomach rising back up your esophagus. This food or fluid can be tasted in the back of the mouth.
When refluxed stomach acid touches the lining of the esophagus and causes a burning sensation in the chest or throat, this is called heartburn or acid indigestion.
Occasional GER is common and does not necessarily mean that a person has GERD. However, GERD is a disease that happens less often and is when reflux is persistent and occurs more than twice a week. Over a period of time it can eventually lead to more serious health problems.
Tips on how to avoid and minimise heartburn
The taste and the discomfort of heartburn can often prevent you from falling asleep or cause you to wake up throughout the night. Reflux may not just be a one-off event and may occur over several minutes, or even hours, during someone’s sleep and hence cause them to feel tired the next day.
Many people manage to control these symptoms by making specific dietary and lifestyle changes and by losing weight (if overweight). Smoking or pregnancy also increase your risk of reflux, so it is advised to cease smoking and if you are pregnant you can try the dietary tips below.
For some people it may be necessary for their doctor to prescribe antacid medication in addition to making dietary changes.
Dietary management of heartburn
The following guidelines are generally advised in an effort to reduce and assist in the prevention of the symptoms of reflux:
Eat slowly and chew food thoroughly.
Avoid large meals and avoid having a ‘completely empty stomach’. In other words, ‘eat small and often’ and space your food intake out over the day by having small, frequent meals and snacks e.g. three meals and 2-4 ‘in between meals’ snacks each day. Try not to go more than three hours without food.
Some foods change the pressure between the stomach and esophagus, increasing the risk of reflux. Other foods may directly irritate the esophagus. Therefore, restrict or avoid the following foods:
- Fatty foods Decrease your intake of creams, oils, shortening, cheese, high fat meats, and food cooked with fats and oils. The Australian Healthy Cooking Guide www.healthy-guide.com assists people with reducing their fat intake as it contains hundreds of low fat cooking tips and easy, tasty, low fat recipes. The Australian Healthy Shopping Guide www.healthy-guide.com also assists people as it lists the lower fat, lower kilojoule, healthier options in supermarkets for many time-saving meals and commercial products.
- Spicy foods and common troublesome spices e.g. chili, curry, garlic, mustards, pepper and cloves.
- Caffeine containing beverages or food, and alcohol e.g. chocolate, alcohol, coffee, and strong tea, particularly at meals.
- Acidic foods such as citrus fruits e.g. oranges, mandarins and pineapple, as well as fruit juices.
Avoid smoking.
Avoid lying down directly after a meal. Try to eat at least two hours prior to lying down to rest or sleep. Raising the head of your bed by six inches so that your head is higher than your stomach when sleeping also reduces reflux.
Drink most of your fluids between – not during – your meals as this helps to prevent overfilling your stomach with food and fluids at the same time. I generally tell my patients to aim to drink most of their fluids half an hour or more before meals and/or one hour or more after meals.
If you are overweight, weight loss can also help to assist in reducing reflux symptoms, in many cases. Again the Australian Healthy Shopping Guide and
the Australian Healthy Cooking Guide can assist people with weight loss as they take the guesswork and hard work out of shopping and cooking healthy, low kilojoule meals.
Try to consume your meals in a relaxed, calm state, and while sitting down. Rushed meals ‘on the run’ and eating when stressed, also aggravates reflux. After completing your meal, rest or relax for half an hour, and try not to rush around to assist digestion. Slow walking is fine if you wish to do some mild exercise.
Try to avoid bending at the waist or straining.
Wear loose clothing, as tight clothes put extra pressure on your stomach.
When to see your doctor
If you are having persistent problems with reflux and heartburn despite trying simple dietary changes, it is important to seek assistance from your doctor. Your doctor will probably prescribe antacids or other over-the-counter reflux medications to relieve your condition.
If however, this continues on for at least another two weeks, your doctor or health care provider may refer you to a gastroenterologist, a doctor who treats diseases of the stomach and intestines. Depending on the severity of your GERD, treatment may involve one or more medical interventions including medications or even surgery. |
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