Extinguish holiday heartburn

So you've just finished the big holiday dinner, and oh, what a dinner it was. For appetizers, you ate bite-sized cheese-filled pastries, mushrooms stuffed with onions and garlic, and deep-fried chicken tenders with spicy dipping sauce. Then a pasta course: manicotti in a meat sauce, plus a large Caesar salad. Next, turkey with oyster-breadcrumb stuffing and a honey-glazed Virginia ham; roasted potatoes, fried zucchini, and creamed spinach. Plum pudding and tiramisu were the dessert choices; you chose both. You washed it all down with two glasses of wine, downed a few chocolate mints, and promptly fell asleep for an hour.

That scenario will probably be repeated in plenty of homes around the country as we enter the holiday season. Equally likely is that some poor person at each of those meals will later find himself scouring the pharmacy shelves in search of something to relieve a distressing bout of heartburn.

The fire within

Heartburn is a burning sensation that begins in the upper abdomen and ascends behind the breastbone up into the throat area, causing chest pain that can sometimes be so severe as to be mistaken for a heart attack. It's often part of a syndrome called dyspepsia, which also includes symptoms such as belching, bloating, and abdominal distention. When dyspepsia or heartburn strikes two or more times a week, it's a good idea to get evaluated by a professional to rule out a more serious problem, such as gastroesophageal reflux disease (GERD) or peptic ulcer disease.

But for most people, incidents of heartburn are episodic and result from eating too much too fast. Rapid distention of the stomach with ingested food, especially high-fat foods, can result in delayed gastric emptying and failure of the lower esophageal sphincter muscle (which normally blocks reflux of irritating acid from the stomach into the delicate esophagus) to close. And snoozing for an hour afterward, rather than staying upright or taking a walk, only compounds the distress.

Dousing the flames

For occasional heartburn, your best bet is a basic over-the-counter antacid. There's a dizzying array of such products, but scattered among the majority are only three active ingredients, all about equally effective: aluminum hydroxide, calcium carbonate, and magnesium hydroxide. Unless you've been advised not to take antacids (for example, because you have kidney disease), pick the least expensive product—liquid or chewable—that has one or two of those ingredients. Store-brand versions of Maalox, Mylanta, Rolaids, and Tums are good options.

If you know that certain foods cause you distress, you can try taking an acid-reducing drug known as an H2 blocker, such as famotidine (Pepcid AC) or ranitidine (Zantac 150), before splurging. Both are available over the counter and as low-cost generics. The stronger drugs called proton pump inhibitors, such as omeprazole (Prilosec OTC and generic) and lansoprazole (Prevacid 24HR and generic), are for recurring heartburn such as that caused by GERD. They shouldn't be used for occasional bouts.

Of course, the best route to good health is prevention. The next time you're invited to a feast—holiday or otherwise—be a gourmet, not a gourmand.