GASTRIC GOLD'S BLOG

Is your heartburn triggered by running, aerobics, or other forms of exercise?

You exercise to feel the burn -- but not that kind of burn. Muscles, yes. Stomach, no. But when you go running, do aerobics, or go to a spinning class, there it is: heartburn. It's not just your legs that are churning, it's your last meal as well, churning right up into your throat. Your exercise heartburn has even made you hesitate to work out and made you wonder: What's going on here?
What Causes Exercise Heartburn?

Exercise can trigger heartburn if the LES muscle (the lower esophageal sphincter) is weak or too relaxed, and food or stomach acid "burps" back up from your stomach into your esophagus.

Exercise-induced heartburn can also be triggered by certain foods -- especially spicy foods like tomato sauce, acidic foods like orange juice, carbonated sodas, coffee, chocolate, and alcohol. These are the most common triggers for heartburn, according to the American Gastroenterological Association (AGA).
6 Tips When Exercise Triggers Heartburn

You don’t need to give up exercise to avoid heartburn. Instead, try these tips:

1. Problem-solve your diet. Do some simple problem-solving, says Tara O'Brien, PharmD, a pharmacy manager at Pharmaca in Seattle, a national, integrative pharmacy combining Western medicine with self-care. "Specifically, do you eat relatively quickly before going for a run? And what types of food?" Cut out the offending foods -- and hold the triple mochas before running.

2. Eat something soothing before exercise. "Some people eat a yogurt before a run and don't experience any problems, while the next person may eat yogurt and experience the worst heartburn ever," says O'Brien. "Experiment with foods to see if one thing aggravates it more than another." Good places to start? A banana, yogurt, small bowl of whole-grain cereal or toast.

3. Eat two to three hours before working out. Play with how long before you exercise to eat your light snack -- a half-hour, hour, 2 hours before -- and see which works best. Maybe you can eat a small snack an hour before exercise with no problem. Or you may need to eat two to three hours before working out to give your stomach time to empty.

4. Rethink your workout. Certain kinds of exercise may trigger heartburn for some people more than others. Experiment to see whether certain workouts trigger heartburn more or less for you. Maybe you can take a spinning class or go hiking if high-impact aerobics or running hurt. Crunches and core work on a full stomach may have to go. Headstands and Downward Dog in yoga, which reverse the natural gravity of digestion, can also trigger heartburn; ask your teacher how to modify these inverted poses.

5. Try baking soda. Taking something for symptoms wouldn't hurt, says O'Brien. Several natural remedies exist, although they only provide temporary relief. Baking soda added to water can help neutralize and wash away stomach acids. Because baking soda may add more salt to your diet, it's best to speak to your doctor first before trying this remedy.

6. Try over-the-counter relief. In your local pharmacy, look for an antacid with calcium -- that's the ingredient that neutralizes stomach acid. "Chewing a Tums or taking a calcium-based antacid is very safe, so it would be worth a try," says O'Brien. Although these are fast-acting, symptom-relief antacids, it can't hurt to try one as a preventive measure before exercise.

You exercise to feel the burn -- but not that kind of burn. Muscles, yes. Stomach, no. But when you go running, do aerobics, or go to a spinning class, there it is: heartburn. It's not just your legs that are churning, it's your last meal as well, churning right up into your throat. Your exercise heartburn has even made you hesitate to work out and made you wonder: What's going on here?
What Causes Exercise Heartburn?

Exercise can trigger heartburn if the LES muscle (the lower esophageal sphincter) is weak or too relaxed, and food or stomach acid "burps" back up from your stomach into your esophagus.

Exercise-induced heartburn can also be triggered by certain foods -- especially spicy foods like tomato sauce, acidic foods like orange juice, carbonated sodas, coffee, chocolate, and alcohol. These are the most common triggers for heartburn, according to the American Gastroenterological Association (AGA).
6 Tips When Exercise Triggers Heartburn

You don’t need to give up exercise to avoid heartburn. Instead, try these tips:

1. Problem-solve your diet. Do some simple problem-solving, says Tara O'Brien, PharmD, a pharmacy manager at Pharmaca in Seattle, a national, integrative pharmacy combining Western medicine with self-care. "Specifically, do you eat relatively quickly before going for a run? And what types of food?" Cut out the offending foods -- and hold the triple mochas before running.

2. Eat something soothing before exercise. "Some people eat a yogurt before a run and don't experience any problems, while the next person may eat yogurt and experience the worst heartburn ever," says O'Brien. "Experiment with foods to see if one thing aggravates it more than another." Good places to start? A banana, yogurt, small bowl of whole-grain cereal or toast.

3. Eat two to three hours before working out. Play with how long before you exercise to eat your light snack -- a half-hour, hour, 2 hours before -- and see which works best. Maybe you can eat a small snack an hour before exercise with no problem. Or you may need to eat two to three hours before working out to give your stomach time to empty.

4. Rethink your workout. Certain kinds of exercise may trigger heartburn for some people more than others. Experiment to see whether certain workouts trigger heartburn more or less for you. Maybe you can take a spinning class or go hiking if high-impact aerobics or running hurt. Crunches and core work on a full stomach may have to go. Headstands and Downward Dog in yoga, which reverse the natural gravity of digestion, can also trigger heartburn; ask your teacher how to modify these inverted poses.

5. Try baking soda. Taking something for symptoms wouldn't hurt, says O'Brien. Several natural remedies exist, although they only provide temporary relief. Baking soda added to water can help neutralize and wash away stomach acids. Because baking soda may add more salt to your diet, it's best to speak to your doctor first before trying this remedy.

6. Try over-the-counter relief. In your local pharmacy, look for an antacid with calcium -- that's the ingredient that neutralizes stomach acid. "Chewing a Tums or taking a calcium-based antacid is very safe, so it would be worth a try," says O'Brien. Although these are fast-acting, symptom-relief antacids, it can't hurt to try one as a preventive measure before exercise.

webmd

Labels: Heartburn

Study Shows Food-Borne Infections Are Linked to Risk of Inflammatory Bowel Disease

Salmonella or campylobacter food poisoning triples the risk of inflammatory bowel disease (IBD) -- for at least 15 years.

IBD typically refers to Crohn's disease and ulcerative colitis. It's not clear exactly what causes IBD. Genetics, environment, diet, abnormal blood vessels, infections, immune-system overreaction, and psychological factors all have been blamed.

To see whether infections play a role, Henrik Nielsen, MD, of Aalborg Hospital in Denmark took advantage of his nation's system of tracking citizen's health records.

The system allowed Nielsen and colleagues to look at whether people who've been treated for certain infections are at higher risk of developing IBD.

The researchers looked at two kinds of food poisoning: salmonella and campylobacter. They identified 13,149 people treated for either infection and compared their health records to those of people who never suffered these infections.

People who had one or the other kind of food-borne infection had a 1.2% risk of getting IBD over the next 15 years. Those who never had either infection had only a 0.5% risk of IBD. Statistical analysis showed that the food-borne infections tripled IBD risk for at least the next 15 years.

"If we can reduce and prevent the spread of food bacteria and infections, we may reduce or even largely eliminate IBD in the long term," Nielsen says in a news release.

Nielsen reported the findings in a presentation to this week's Digestive Disease Week (DDW), held May 30 to June 4 in Chicago. DDW is an annual conference sponsored by the American Gastroenterological Association, the American Association for the study of Liver Diseases, the American Society for Gastrointestinal Endoscopy, and the Society for Surgery of the Alimentary Tract.

Labels: Inflamatory Bowel Disorders

There are many good reasons to quit smoking. They range from curing your bad breath to reducing your risk of cancer, heart disease, and lung disease. But here's another reason to add to that long list: tobacco -- not just in cigarettes, but in cigars, pipes, chew, and snuff -- can cause heartburn.

"Tobacco makes acid reflux worse," says David Carr-Locke, MD, director of endoscopy, Brigham and Women's Hospital, Boston. "It's definitely a risk factor."

And unlike a heightened risk of serious diseases -- which might seem rather abstract, especially when you're young -- heartburn is a consequence of tobacco use that you can feel right now. And chronic heartburn, due to gastroesophageal reflux disorder (GERD), can cause more than serious pain; it can disrupt your sleep and interfere with your life. Sleeping With Heartburn Carries Cancer Risks.
Healing the Heartburn

According to some experts, there's a simple solution to the heartburn/tobacco equation, although you've probably heard it before: quit.

"For some people, quitting tobacco use can be the difference between having GERD and not having it," says Lawrence J. Cheskin, MD, co-author of Healing Heartburn and associate professor at Johns Hopkins School of Medicine in Baltimore. "If you stop, your symptoms will probably get better quickly. It also really lowers the risks of having further complications down the road."

However, not everyone thinks that quitting tobacco use will necessarily have a dramatic effect on heartburn.

"I think that quitting only has a modest impact on GERD symptoms," says J. Patrick Waring, MD, a gastroenterologist at Piedmont Hospital in Atlanta. But he still strongly encourages anyone who uses tobacco to kick the habit.
How Does Tobacco Affect GERD?

When you eat, a muscular ring between the end of the esophagus and the entrance to the stomach -- called the lower esophageal sphincter (LES) -- relaxes to let food in. Once it has closed again, the stomach releases acids and enzymes to break down the food.

Usually, these acids stay put in the stomach. But in people with GERD, the sphincter may stay relaxed or relax at the wrong time. This allows stomach contents containing acids and enzymes to wash back up, irritating the tissue of the esophagus.

Experts believe tobacco might worsen heartburn in a number of ways, including:

* Impairing the function of the LES. "The nicotine in tobacco seems to lower the pressure in the lower esophageal sphincter," says Cheskin. The reduced pressure could allow stomach acids and enzymes to back into the esophagus.
* Increasing acidity. Nicotine increases the production of stomach acid, says Carr-Locke.
* Harming the esophagus. Tobacco smoke seems to directly irritate the esophagus lining, says Cheskin.
* Reducing saliva production. This causes two problems. When you swallow, saliva helps push acid down, out of the esophagus and into the stomach. Saliva also contains bicarbonate, which is a mild acid neutralizer, says Cheskin. So a reduction in saliva can make your acid reflux worse.

Only the effects of smoked tobacco have been seriously studied on GERD symptoms, say experts. But anything with nicotine is likely to worsen GERD. Waring says that chew might pose specific problems.

"Smoking a cigarette only takes a few minutes," he says. "But people use chewing tobacco all day. That could lead to more irritation."

By the same token, nicotine gum could also pose a risk, say experts. "I don't know of any studies on nicotine gum and GERD," says Cheskin. "But I would worry that anything with nicotine would increase the risk of acid reflux."

Tobacco use also increases the long-term risks of GERD. Acid reflux is more likely to damage the esophagus in people who use tobacco than in people who don't. The damage will heal more slowly too, Cheskin says. Over time, tobacco users are more likely to face complications of GERD. These include chronic inflammation of the esophagus and even esophageal cancer.
Quitting: Will It Help Your Heartburn?

Cheskin says that cutting out tobacco will almost certainly ease heartburn symptoms.

"I think most people would feel the benefit of quitting within a few days," says Cheskin. He says that it's possible that cutting down your tobacco use -- rather than stopping cold turkey -- might help. But he strongly encourages people to quit.

Yet not everyone is sure that quitting makes a big difference.

"It's true that people with GERD who smoke tend to have symptoms that are more pronounced than people who don't smoke," says Waring. But there isn't good evidence that symptoms improve when people quit using tobacco, he says.

"I think tobacco only plays a minor role in acid reflux," he tells WebMD.

The results of research have been mixed. One 2004 study published in the journal Gut found that smoking tobacco had a strong cumulative effect on GERD symptoms. For instance, the study found that people who smoked everyday for twenty years were 70% more likely to have GERD than those who smoked daily for less than a year.

But a 2006 analysis published in the Annals of Internal Medicine found that while there was a connection between smoking and GERD, quitting didn't necessarily help resolve the symptoms.

So cutting out tobacco use may not cure you. Even if you ditch the cigarettes or chew, you might still have heartburn symptoms. But these may be controlled by other lifestyle changes or medicine.
Getting Control of Your Heartburn

Obviously, quitting tobacco isn't easy. Talk to your doctor about different strategies. You'll certainly need the support of your family and loved ones. You might also consider joining a support group to help you cope.

But just remember that while quitting is tough, you will probably feel a lot better for it. While many people might think of heartburn as an occasional discomfort, people with GERD know how painful and debilitating it can be. Quitting tobacco use could be a first and important step in getting control of your condition.

"If there already weren't enough reasons for you to quit smoking," says Cheskin, "resolving your heartburn is one that you can really feel."

WebMd

Labels: Heartburn, Tabacco