HEART BURN

SOME people believe that if an expectant woman suffers heartburn, she is carrying a child with long hair. This also implies that the child will be a girl. However, these suspicions have no medical backing. Some babies have been born without hair, yet their mothers suffered heartburn while pregnant.

For some, it sounds somewhat confusing to use the term heart burn because they end up believing the burning sensation is something related to the heart. Of course heartburn has nothing to do with the heart!

It also happens that some people with heartburn say their liver is aching. They believe that the liver is at the centre of the chest. There are also those who touch below their belly button and say their stomach is aching. They do not realise that most of what they call ‘stomach’ is actually occupied by intestines.

In order for one to understand heartburn, it is important to comprehend where the stomach is located in relation to the uterus. During the first trimester, there are many women who cannot tell whether the stomach is below or above the uterus, or whether the growing baby is closer up to the chest or lower down towards the belly button.

Heartburn is a burning sensation in the chest and throat, at times accompanied by a sour acidic taste in the mouth. Most pregnant women experience heartburn at some point during their pregnancy. Heartburn can occur either during the first trimester or last trimester. Some women are more severely affected than others.

There are people who suffer from heartburn but believe they have stomach ulcers. It is important to differentiate between these two; stomach (or duodenal) ulcers cause more pain when the stomach is empty, whereas heartburn reduces as the stomach empties.

How heartburn occurs
Ordinarily when a person swallows food, it goes down the throat and smooth muscle contractions push it into the oesophagus -the canal that leads into the stomach. At the end where the oesophagus meets the stomach there is a ring-shaped muscle (called sphincter) which opens up to allow food passage into the stomach and then doses tight to ensure the food stays in the stomach. The sphincter thus prevents food from finding its way back into the oesophagus. There are certain circumstances, however, that can lead to the sphincter being slack, hence allowing acidic fluids and other substances from the stomach to reflux (flow back upwards).

Acidic reflux irritates the lining of the oesophagus, leading to the burning sensation known as heartburn. This explains why heartburn is most severe when the stomach is full, especially after large meals and spicy dishes. Lying down makes acidic reflux easier, explaining why sitting up reduces the sensation. It is for this same reason that doctors encourage small meals over the day and discourage large servings at dinner and late night eating habits.

Heartburn during pregnancy
Once a woman conceives she produces a sex hormone called progesterone, which promotes the formation and maintenance of the pregnancy. Progesterone also relaxes plain muscles throughout the body, including sphincter, thereby reducing its muscle tone and weakening its effectiveness in retention of stomach fluids. This allows gastric acids to seep back from the stomach, upwards into the oesophagus, leading to unpleasant burning sensations in the chest area.

Progesterone also slows down the wavelike contractions of the esophagus and intestines, making digestion sluggish. This causes slow movement of food substances, hence a higher tendency for food and fluids to seep backwards because of the backlog.

In addition, the growing foetus takes more and more space as pregnancy progresses, and pressurises the other abdominal organs, including the stomach. This squashes the stomach contents, leading to reflux and heartburn. For this reason women in the third trimester may complain of increasing regularity and severity of heartburn.

How to reduce heartburn

For large meal eaters, the first caution is bad news- don’t eat as much; at least not all of it at once! It is better to eat six small meals a day instead of three big meals. Smaller meals will find their way into the stomach and will not pressurise the sphincter, even if its muscle is weak.

For fast eaters, it is bad news too: Eat slowly! While eating take small bites and chew your food well. Do not put in you mouth more food than you can comfortably chew.

For those who eat as much as they are served, the caution is: you do not have to finish everything! Over feeding can make heartburn worse. Keep in mind that the stomach is in reality not your entire belly (which holds the intestines and other organs), but only a much smaller ‘bag’ located just below your left hand side rib-cage (see earlier diagram).

For fatty first food lovers and those who regularly indulge in spicy Indian cusine, it is time to review your diet.

Carbonated drinks, chocolate, citrus and products with caffeine such as coffee should also be avoided.

Avoid drinking large quantities of fluids during meals because this will expand your stomach and put more pressure on the sphincter.

While going about your daily business, avoid bending at the waist—if appropriate, bend your knees instead.

After eating, it is advisable to wait for at least one hour before you can I e down on that couch or your bed. While sleeping, pop yourself up using a few pillows, to keep your stomach acids lower down. Sleep on your side, not your back or on your stomach.

END:PG12/14-15