Holiday Heartburn

Eileen K. Carpenter, MD, an internal medicine physician at Penn Medicine Washington Square, discusses how to avoid holiday heartburn and when you should get it checked out.

Eileen k Carpenter, MD

Some food for thought: Every Thanksgiving night, there are many cases of emergency room visits due to chest pain.

Something else for you to chew on: Most of these visits can be prevented.

The most common reason for chest pain is gastro-esophageal reflux disease (GERD) – stomach acid washing backward up the esophagus (food pipe). And while the stomach is designed to handle strong acids, the esophagus is not. If the refluxing acid doesn’t get swallowed back down promptly, it can cause a painful chemical burn in the esophagus.

Thanksgiving is a perfect storm of GERD risk factors. People’s stomachs are way too full by the end of dinner. Then, they top the evening off with a late dessert of high-fat pie, ice cream and a cup of coffee. Caffeine and fatty meals predispose you to reflux, and if your stomach isn’t empty by the time you go to bed, gravity pushes the acidic stomach contents up the esophagus.

Can you prevent acid reflux?

Luckily, you can prevent reflux pain. The best way is to fast for two to four hours before lying flat and by timing your fatty or caffeinated intake to occur earlier in the day. Liquid antacids, like Maalox, Mylanta or Milk of Magnesia, provide near-immediate relief of reflux, so it’s a good idea to have a bottle in the house for the holidays. (The effective dose is two tablespoons.)

If there has been significant irritation of the esophagus, the pain may return a few hours later, and acid-suppressing medications like ranitidine or omeprazole will help heal it. If it takes more than two weeks for a reflux flare-up to resolve, it’s time to see your doctor to make sure there’s nothing else going on.

It’s important to keep in mind…

Chest pain due to the heart is also more common during the holidays. People are away from home and their usual medication routine; they’re drinking more alcohol and enduring more stress. If you are traveling, make sure to bring your medications and continue to take them as prescribed. Limit alcohol to one to two drinks a day for women and two to three drinks a day for men, or abstain completely.

If you think you have chest pain due to reflux, but the liquid antacid doesn’t knock it out immediately, call 911 to make sure it’s not your heart.

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