Lifestyle changes mean modifying things we have control over. It involves factors that may bring on symptoms or make them worse, such as dietary changes or changes in daily routine. Certain medications can aggravate symptoms. Disclose the use of any medications to your physician.

Heartburn is the burning sensation in the chest behind the breastbone that we feel when stomach acid refluxes back into the esophagus (food tube). If you have this symptom, there are a number of things that you may be doing that brings it on and some things you can do to help prevent it.

Gravity plays an important role in controlling reflux. If lower esophageal sphincter (LES) is weak, then after a large meal, food comes back into the esophagus and heartburn occurs. If you experience heartburn, think whether it occurs after meals, when you lie in bed at night, or if you take a nap after a meal. Maintaining an upright posture until the meal is digested may prevent the heartburn. If heartburn occurs regularly at night(nocturnal GERD), consider raising the head of the bed. Avoid exertion after a meal. This is especially true of tasks that require bending such as lifting or cleaning the floor.

Tip: Don’t lie down within 3 hours of eating. That’s when acid production is at its peak, so plan early dinners and avoids bedtime snacks.Elevate the head of your bed at least six inches. If possible, put wooden blocks under the legs at the head of the bed. Or, use a solid foam wedge under the head portion of the mattress. Simply using extra pillows may not help.

A large meal will empty slowly from the stomach and exert pressure on the LES. A snack at bedtime increases the chances of reflux. It is best to eat early in the evening so that the meal is digested at bedtime. You might try having the main meal at noon and a lighter one at dinnertime. All meals should be eaten in relaxed stress-free surroundings. Smaller meals and an upright, relaxed posture should help minimize reflux.

Tip: Avoid large meals, especially late in the day. Try to make your main meal the mid-day meal.

Certain foods compromise the sphincter’s ability to prevent reflux, and are best avoided before lying down or exertion. These differ from person to person. Many person find that fats, onions, and chocolate as particularly troublesome. Alcohol often provokes heartburn, by compromising the LES, irritating the esophagus, and by stimulating stomach acid production. Common beverages such as coffee (both caffeinated and decaffeinated), tea, cola, tomato juice, and citrus juice may aggravate symptoms by irritating the esophagus or stimulating stomach acid production.

Tip: Experiment to find what does and does not work best for you. Start by reducing fatty foods, onions, and chocolate. Use lozenges or gum to keep producing saliva.

Being overweight can promote reflux. Excess abdominal fat puts pressure on the stomach and the loss of even a moderate amount of weight makes many people feel better.

Pregnancy is often troubled by heartburn, particularly in the first three months. Certain hormones appear to weaken the LES, and the increasingly crowded abdomen encourages reflux.

Tip: Avoid wearing tight-fitting garments. Increased pressure on the abdomen can open the esophageal sphincter.

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