Acid Flashbacks

If you have reflux, you know how it feels when food returns to hauntyou. Dr John Brififa suggests several strategies for taming heartburn at night

While a good evening meal can send us to bed in a contented state, our last supper may also make its presence felt later in the form of acid indigestion and heartburn.

A recent study in the American medical journal Chest has revealed that imbibing carbonated drinks in the evening appears to increase the risk of the acid reflux at night. It has been suggested that the acidic nature of these drinks adds to the stomach's own acidity, thereby increasing the risk of heartburn.

My experience is that many other nutritionally oriented approaches can neutralise this problem. A top tactic is to ensure that food is well digested before retiring - food can overstay its welcome in the stomach, increasing the risk that it will leak through the valve between the stomach and the gullet (the gastro-oesophageal sphincter, or GOS). Lying down ups the risk of the stomach content escaping into the oesophagus.

One approach for overcoming reflux at night is to avoid overwhelming the stomach with food in the evening. A modest-sized supper is a good ploy - this is more easily achieved if, after a half-decent lunch, you have a snack of, say, fruit and/or nuts in the late afternoon. An earlier dinner may help, too.

Although recent evidence suggests that fizzy drinks should be given a miss in the evening, my advice is to keep intake of all fluids to a minimum around the time of the evening meal. Drinking dilutes stomach acid, impairing digestion. Additional fluid also adds volume to the stomach contents, which tends to increase reflux risk.

Alcoholic beverages seem to be a particular problem, as they promote laxity in the GOS. For those prone to reflux at night, it seems that a night-cap of whisky and soda is something well worth avoiding.

One often-effective strategy for refluxers is to avoid mixing protein-based foods (such as meat, fish and eggs) with starch-based foods (bread, potatoes, rice and pasta) at the evening meal. This means basing meals on either protein or starch, along with cooked vegetables (other than the potato) or salad.

Some believe that this makes digestion easier, and my experience is that it is often very effective in the treatment of heartburn.

Further digestive aid can be had from thorough chewing, which breaks up food and allows the digestive juices greater opportunity to do their job.

A range of natural approaches can do much to help those prone to feeling the burn at night.

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