Diet and Heartburn

SYMPTOMATIC gastroesophageal reflux (heartburn) is a ubiquitous postprandial complaint. Although usually a recurring complaint, it can be transient (as in the third trimester of pregnancy) or persistent and progressive (as in progressive systemic sclerosis). Regardless of frequency, gastroesophageal reflux produces annoying symptoms for which medical attention is sought. A characteristic feature of heartburn is its relation to food ingestion. Thus, medical advice concerning antireflux dietary adjustments is appropriate.

Although no specific smooth muscle sphincter is demonstrable anatomically at the esophagogastric junction, a physiological high-pressure zone exists in this region to prevent regurgitation of acid-peptic stomach contents into the esophagus. In the normal human esophagus, this lower esophageal sphincter (LES) exerts a squeezing pressure of approximately 15 to 20 mm Hg greater than that within the stomach. Failure to maintain this normal pressure barrier results in sphincter incompetence and creates the potential for gastroesophageal reflux.¹

Effects of Foods on the