Holidays Are Season to Brace Yourself for Heartburn by Gina Shaw Deck the halls with boughs of Ö Nexium? ëTis the season to be Ö extremely uncomfortable? As December ushers in the traditional holiday parties and celebrations of many cultures and faiths, tagging right behind the feasting is another holiday tradition: heartburn. Anyone can overeat at the office holiday party or a festive family gathering. Itís hard to resist Aunt Dorisís famous pumpkin-chocolate pie with whiskey-pecan sauce, after all. National statistics affirm that about 15 million of us experience heartburn and acid indigestion periodically. But for some 7 million people in the United States alone, these symptoms are not just periodicótheyíre chronic and are part of a condition known by the tongue-twisting name of gastroesophageal reflux disease, or GERD. For people with reflux, navigating the culinary temptations of December can be much trickier. A series of barriers normally keeps our stomach acidóthe stuff that breaks down our foodófrom backing up into the esophagus and even the throat and mouth. One of these barriers is the sphincter, which keeps the lower end of the esophagus closed when youíre no t swallowing. Others are the muscles of the diaphragm, which encircle the esophagus. ìThere are a number of things that form a barrier from injury. Your esophagus may be built to withstand a little more injury than someone elseís, for example,î explained Dr. Gulchin Ergun, associate professor of medicine at Baylor College of Medicine in Houston and director of the Reflux Center at the Methodist Hospital. But if one of those dominoes in the injury barrier falls, stomach acid backs up, overflows into the esophagus, andóurpóyou have reflux. ìEverybody has some small degree of reflux normally. But if you have excess exposure, people can get chest pain or heartburn,î Ergun said. And heartburn loves the holidays, when virtually every item on the menu appears designed to contribute to reflux. ìFatty foods, like ham, gravy and pie, slow down the emptying of the stomach. Thatís why you get that leaden feeling in your stomach after eating a meal with lots of fat. They also release a hormone called CCK that drops the tone of the sphincter and relaxes it, which means itís less effective as a barrier,î Ergun explained. ìCaffeine and alcohol stimulate acid production. And then there are foods that are acidic themselves, which includes just about anything sour.î That means you, cranberry sauce! So you get a little heartburn after a big holiday meal. The indulgence is worth some short-term discomfort, right? Not necessarily. Heartburn once a month or so may be no big deal, but if you are experiencing reflux symptoms a couple of times a week or more, you could have GERD or another reflux-related condition. And over the long term, that can lead to bigger problems. ìPeople can get an injury caused by inflammation in the esophagus, called esophagitis. As that tries to heal, it can lead to changes in the lining, which is a condition called Barrettís esophagus,î said Ergun. About one in 10 people with GERD have Barrettís esophagus, which can lead to esophageal cancer in up to 5 percent of cases. Thatís not all that can go wrong. Stomach acid backing up into your mouth can mean more than just an occasional bad tasteóit can lead to laryngitis, aggravate asthma and even cause dental problems. Untreated inflammations can also cause internal bleeding. ìPeople need to recognize that this isnít just a nuisance,î Ergun said. So when confronted with the tempting tables laden with holiday goodies, donít just jump in now and figure youíll pay later. ìYou hate to tell people to give up everything they want, and people wonít do that anyway,î Ergun said. ìSo the key is moderation.î Instead of one piece of each of the five pies everyone brought to the holiday potluck, have only half a piece and sample just two. Go easy on the eggnog and champagne, and if you know youíll be drinking alcohol at a party, cut back on the dayís cups of coffee. Be particularly sparing with highly acidic foods, such as cranberry. You can also limit the effects of reflux by doing just what you donít want to do after a big holiday meal: moving around. If you sprawl on the couch to watch the game after gorging yourself, that makes it much easier for stomach acid to move up. ìYou want to be upright after a big meal to prevent reflux,î said Ergun. Instead of a nap, take a walk, play a game of soccer, or build a snowman if the weather cooperates. If heartburn attacks despite all of your best intentions, over-the-counter antacids usually provide quick relief for acid indigestion and upset stomach. But if you have symptoms more than twice a week or any of what Ergun calls ìalarm symptomsîótrouble swallowing, severe chest pain, or atypical signs such as waking up hoarse or coughing with acid in your mouthóthen itís time to see a doctor. Gina Shaw is the medical writer for The Washington Diplomat.