The Key Is Not Always Which Foods You Eat, But How Much
In 2010, Tanya Donovan graduated from college and started looking for a job. She submitted more than 450 applications and went on over 75 interviews before she finally found a position half a continent away from her friends and family.
Tanya handled most of the stress of the move and the new job well, but a few weeks later she started waking up every morning with a bitter taste in her mouth. Then she started getting laryngitis even when she did not have a cold or allergies. In a few more weeks, she started having horrible heartburn, the kind of condition she thought only bothered fat, bald men who smoke cigars, acid reflux. Heartburn after nearly every meal made her life miserable.
Tanya's case is hardly unique. A Gallup poll estimates that nearly 130,000,000 people in the United States alone suffer at least one acid reflux event every month. Nearly 15,000,000 deal with acid reflux every day. Gastroesophageal reflux disease is common during pregnancy, and it seems to be becoming more and more common in the population at large.
Tanya found relief after her 90-day waiting period for health insurance expired and she went to a doctor for advice. Tanya started taking the proton-blocker called Prilosec, which decreases the production of stomach acid (and also, of course, the digestion of food). Judging by the $10 billion a year sales of Prilosec and related drugs, many people are trying the same kinds of medications.
But Tanya wanted to do more than just rely on medications. To avoid problems from poor digestion of essential nutrients, Tanya also started taking calcium and mineral supplements, and she also started being very careful to avoid Mexican food, Thai food, Szechuan food, hot sauce, and chili peppers. But avoiding spicy foods didn't really seem to help. In fact, her heartburn was less of a problem when she ate them.
The Paradoxical Effects of Fiery Foods on Heartburn
The effects of fiery foods on acid reflux are usually the exact opposite of what common sense would seem to predict. Chili peppers and Szechuan peppers usually do not set off an acid attack. In fact, they usually prevent them. The remedy in Traditional Chinese Medicine for heartburn even is a mixture of Szechuan peppers and malted barley (although this does not mean you should run out to a Chinese all-you-can-eat buffet and wash it all down with a good Chinese beer). Why should fiery foods relieve heartburn?
The reason fiery foods don't cause fiery stomachs is the same reason that they make many people cry. They stimulate the vagus nerve.
The vagus nerve controls the tear ducts, many movements of the mouth, the movements of the muscles that keep food flowing downward through the throat and past the esophagus, the movements of the muscles that propel food out of the stomach into the intestines (rather than in the opposite direction), and the speed of the pulse. People who have heartburn also tend to have problems with speech or burping or constipation, in part because of the sluggish activity of the vagus nerve.
Hot peppers stimulate the vagus nerve. They make eaters cry, but they also stimulate the muscles that hold food down and keep stomach acid from flowing up. Rather than making heartburn worse, they actually reduce acid reflux and make heartburn better.
Bitter Foods Also Relieve Acid Reflux
Peppers are not the only food with a paradoxical power to relieve heartburn. Bitter foods are also helpful in treating the condition, especially when fatty foods make acid reflux worse. The way bitter foods help control the regurgitation of stomach acid is by helping the stomach make more stomach acid.
When there is more acid in the stomach, food is digested more quickly. When food is digested more quickly, there is less time for it to "repeat" and send stomach acid into the throat. Salads with endive or radicchio, or a cocktail hour drink of tonic water, quinine water, or Angostura bitters all help increase acid production and decrease acid reflux.
Medical researchers have found that, on average, the stomach of someone who suffers acid reflux produces about 20 percent less acid than then stomach of someone who does not have the condition. When it comes to stopping acid reflux, it is not necessary to stop acid production with Nexium or Prilosec. It's better to increase acid production with simple food cures like salad and tonic water.
Are there any foods that increase acid reflux? The real problem isn't what you eat, it's how much you eat. Eating less usually relieves symptoms.
- High-calorie meals increase the severity of acid reflux.
- High-fat meals increase the frequency of acid reflux attacks.
- Acid reflux after you eat is caused by the pressure of liquids in the stomach. If you simply eat less, there is less pressure on the stomach to send stomach acid upward.
- Acid reflux when you are fasting is caused by the pressure of gases in the stomach. If you avoid carbonated beverages, there is less pressure on the stomach to send stomach acid upward. Sugar-sweetened soft drinks, diet soft drinks, and seltzer water all have the same effect.
And what about chocolate, coffee, alcohol, and tobacco?
All of these substances contain chemicals that reduce the "grip" of the lower esophageal sphincter keeping the valve to the stomach shut while food is being digested. However, a weaker esophageal sphincter is less of a problem when there is less pressure on the other side of it. If you consume these substances, at least eat smaller meals and avoid carbonated beverages.
Orange and grapefruit juice aggravate acid reflux only in susceptible individuals. Some people who have acid reflux cannot drink citrus juices at all, while others can drink all they want with no problem. The acidity of fruit juice is always much less than the acidity of stomach acid, and a more or less "acid" juice has no effect on the stomach. The problem chemical is in the pulp or the peel that gets mixed into the juice.
Posture also makes a difference. Sitting up straight while eating and after meals keeps digested food and digestive juices in the stomach. If you must take an after-meal nap, try to wait at least 90 minutes, to give your digestive tract time to send your meal out of the stomach and into the small intestines.