Esophagus

Esophagus

The esophagus is a simple tube that functions like a laundry chute. Put in food at the top, and it plummets about ten inches down through the esophagus to the stomach.

There''''s one catch--or, rather, hatch. At the juncture with the stomach, the esophagus has a circular muscle--the lower esophageal sphincter (LES). When food needs to get into the stomach, the sphincter opens. Then it squeezes shut. No exit!

Splish-Splash, It''''s an Acid Bath

If the LES opens when it shouldn''''t, however, stomach acid can leak back up into the esophagus. This may cause a burning chest pain called heartburn.

Sometimes the sphincter is weak, and if someone strains to lift weights or go to the bathroom, that can cause it to open, says Malcolm Robinson, M.D., gastroenterologist at the University of Oklahoma Health Sciences Center in Oklahoma City. Other times, the sphincter just relaxes. Extra body weight can exert force on it. Some medications can cause LES pressure to drop, he says, so read the labels on any over-the-counter medications that you''''re taking or check with your doctor about side effects if you''''re getting a prescription.

Pregnant women tend to get heartburn more often, and that''''s because of hormonal changes, according to Dr. Robinson. "Increased levels of progesterone have been shown to weaken the muscle." This can also be a problem for women who take oral contraceptives high in progesterone, or progesterone-only forms of birth control such as Norplant or Depo-Provera.

Whatever is aggravating your heartburn, here''''s what doctors recommend to fend off the fire.

Eat small, eat early. Instead of two or three large meals a day, eat five or six smaller ones, says Frank Hamilton, M.D., director of the Gastrointestinal Disease Program Branch at the National Institutes of Health in Bethesda, Maryland. Your stomach will secrete less acid. "We also find that people get more heartburn when they eat late at night, so eat earlier and wait a few hours before going to bed."

Dine selectively. High-fat foods can trigger heartburn, because your stomach doesn''''t empty out as fast when you''''ve eaten these foods. "The worst food of all is the onion," says Dr. Robinson, because it provokes multiple LES relaxations. Other trouble foods include orange juice, tomatoes, spicy foods and coffee, both caffeinated and decaffeinated.

Shed some weight. If you''''re overweight, losing a few pounds may help relieve your heartburn, says Dr. Hamilton.

Give your bed a tilt. When you lie down, you''''re more susceptible to heartburn, because it''''s easier for acid to roll into your esophagus. It can help to elevate your chest higher than your abdomen, says Dr. Robinson. Put blocks of wood under the head of your bed to prop it up five or six inches, he suggests. Or lie on a wedge-shaped pillow.

Check your medications. If you take asthma or anti-hypertensive medication and get heartburn, ask your doctor whether the medications could be causing the problem, Dr. Hamilton suggests.

Try an antacid. If you know your chest pain is just heartburn, use an antacid, doctors say. Dr. Robinson recommends tablet antacids, because they mix with your saliva and create a gummy substance that coats your esophagus--which may give you longer relief.

See also Digestive System