Q Dear Doc, I know I am getting up in age, but I am dating a woman much younger than I. We have been partying for the holiday season but I can’t keep up. Every time we go either to a Christmas party or regular party and drink, the next day, I feel awful. My belly feels like a mess, I can’t eat, and I feel a pain in my chest, and it’s like I want to vomit and keep bringing up bitter vomit.
I still have New Year’s to survive and I don’t want to disappoint her, because it’s our first Christmas together. Is there anything I can take to not feel so terrible?
A This sounds like a typical case of acid reflux commonly called heartburn or indigestion.
It’s the holiday season, and all our favourite comfort food, big holiday dinners, the parties, and happy-hour drinks are all a recipe for heartburn. Alcohol, caffeine, and eating too much fatty foods are all common causes of indigestion. The holiday dinners are especially a problem, because once you have stuffed yourself, the urge to sleep kicks in, then you move to the couch. This results in stomach acid spilling into the oesophagus.
This is what causes that burning feeling in the chest that works its way upward.
There is a little muscle that sits between the oesophagus and the stomach. With ageing, that muscle gradually relaxes, causing stomach acid to spill into the oesophagus much more easily.
When standing, gravity helps to keep stomach acid from migrating upward. But when we lie flat, especially with a full stomach, stomach acid, gets pushed into the oesophagus. Excess fatty food slows down digestion, making heartburn almost a certainty.
The run-of-the-mill heartburn is easy to treat, and now, during the holiday time, where there is increased use of alcohol, and the overstuffing of the stomach, all these will make heartburn worse. Treating it aggressively with over-the-counter or prescription medicines will be the easiest way to improve your symptoms.
For best results, take your heartburn medicine before the heartburn starts, such as before having a big holiday meal, or heading to the party, or before bedtime after the party.
Common over-the-counter heartburn medicines include:
– Antacids such as Andrews and Tums which neutralise stomach acid to relieve heartburn.
– Acid blockers reduce the production of stomach acid and include Pepcid AC, Prilosec OTC, and Zantac 75.
For severe heartburn that isn’t relieved by these medications, prescription medication may be necessary. The prescription medications contain higher doses than the over-the-counter versions. for example Nexium.
To better help with controlling heartburn, the following are also helpful:
– Eating only until you are full.
– Know the foods that irritate your stomach, the ones that trigger heartburn, and stay away from them. These tend to be onions, chocolate, citrus juices, tomatoes, soft drinks, coffee, and alcohol.
– Don’t eat too close to bedtime. Stop eating four hours before going to bed.
– Take a walk after dinner. It’s a good habit to get into, because it helps food digest, which prevents heartburn.
– Don’t wear tight pants. Tight pants constrict your stomach, which makes heartburn more likely.
If the symptoms persist, see your doctor so that prescription-strength medication can be prescribed and other investigations performed.