Holidays without heartburn, Part 2: Beverages

Phew! You made it through Thanksgiving without heartburn, but that was just the beginning. The holiday season is now in full swing, and there are still plenty of potential pitfalls ahead. After all, hot chocolate and creamy eggnog are all part of the "fa la la" and "Auld Lang Syne," right? Here's how to celebrate the season without heartburn. But first, a quick refresher on how and why heartburn happens.

Getting to the Heart of Heartburn

"Reflux and heartburn are the same thing, except that reflux describes what is happening, whereas heartburn is what you are feeling," explains Dr. Lauren Gerson, a gastroenterologist and associate professor of medicine at Stanford University School of Medicine. The main reason people get heartburn is because the sphincter muscle at the base of the esophagus -- the tube that carries food down to your stomach -- relaxes more than it should. This, in turn, allows acidy stomach contents to travel back up the pipe, explains Gerson. When this acidy reflux hits your esophagus, you get burning pain in the middle of your chest. If this happens regularly, it's called gastroesophageal reflux disease, or GERD, which is just a fancy way of saying chronic heartburn or chronic reflux.

While many foods and drinks can worsen heartburn, the good news is that not all heartburn triggers bother all heartburn sufferers. The key: find out what bothers you. Common culprits include alcohol, chocolate, citrus, coffee, peppermint, tomatoes, some spices and fat. To figure out which of these are a problem for you, keep a food diary for a few days or a week, then avoid each suspect one at a time to see what helps. "Some [heartburn sufferers] can drink coffee forever, while others run for relief after one sip of orange juice," says Pat Baird, a registered dietitian specializing in intestinal disorders and the author of Be Good to Your Gut.

Think Before You Drink

In general, liquids are less likely to cause problems than solid food, says Gerson, because liquids empty from the stomach faster than solids and are often lower in fat. Of course, that theory goes out the window if you are fond of milkshakes or eggnog. Still, here's how you can keep beverages from doing you in as you linger over latkes, trim the tree and ring in the new year.

• DO keep a food diary to help you pinpoint the culprits when heartburn keeps you up at night.
• DO pay attention to the amount of fat in your holiday drinks. Most recipes won't suffer if you cut back up to half of the fat.
• DO buy low-fat eggnog. Try a few brands to find one you like, make it yourself with skim or 1 percent milk, or go wild with soy eggnog!
• DO go for "Shirley Temple" drink options -- your guests might appreciate them as well.
• DO order your lattes "skinny" (made with skim milk) and "tall" (small) instead of "venti" (as in, super-sized). Your waist and heart will thank you as well.
• DO consider switching some of your coffee mugs for teacups: Tea is less irritating.
• DO satisfy a chocolate urge with hot cocoa instead of chocolate candy, which may be more likely to trigger heartburn. 
• DO make hot chocolate with skim milk and top it with marshmallows (they're fat-free!) instead of whipped cream.
• DON'T overdo it -- whether it's filled with food or drink, a stuffed tummy is just asking for heartburn.
• DON'T forget to exercise. Find excuses to keep standing and moving instead of sitting back or lying down after you eat.
• DON'T drink high-fat beverages close to bedtime.
• DO raise the head of your bed. Use 6-inch blocks instead of just propping yourself up with pillows.
• DO sleep on your left side; research shows this can reduce nighttime heartburn because it allows your stomach to empty more easily.

Happy heartburn-free holidays!

Susan Male-Smith is a registered dietitian and freelance nutrition and health writer. She has written for Family Circle, Redbook, Child and American Health, and she is a former editor of the Environmental Nutrition newsletter and co-author of Foods for Better Health.