More than a year into the pandemic, many people have grown used to a new lockdown lifestyle: staying home, exercising less and eating more—all while experiencing greater levels of stress and anxiety.
“All of this contributes to worsening gut function,” says Christopher Andrews, the lead physician at the Calgary Gut Motility Centre, adding that heartburn is on the rise. Some experts have even given the trend a name—“pandemic stomach”—and last December there was a temporary shortage of antacid medication in the United States.
Heartburn, a fiery sensation in the chest or upper belly, is the painful effect of the stomach’s acid and digestive enzymes creeping into the esophagus. When you swallow food or liquid, your esophageal sphincter, the muscle around the bottom of your esophagus, relaxes to allow the contents to move down, then closes to prevent backup. But if that muscle weakens or is unable to close completely, stomach acid might rise, causing irritation.
Diet is the most common culprit: acidic foods such as grapefruits, hot sauce or coffee increase the amount of acid in your stomach, while chocolate, alcohol and high-fat foods, such as cheese or avocados, stimulate the release of hormones that loosen the sphincter. Spicy food can also increase uncomfortable sensations in the gut.
Heartburn occurs in bodies of all sizes, ages, ethnicities and genders, but researchers have found that overweight people are more at risk. According to a major 2006 study, overweight and obese participants were two to three times more likely to experience frequent heartburn than those with a healthy weight. This may be because of the increased pressure on the gut, Andrews says, which can push stomach acid up. Changes in diet, such as the recent tendency of people to lean on carbs and comfort food in lockdown, can also lead to more bloating and gas in the digestive tract—again putting a squeeze on the gut.
Stress and anxiety are factors because the sympathetic nervous system—which triggers the body’s “fight or flight” response—also interacts with the enteric nervous system, which regulates digestion. In fact, during life-threatening situations, a person’s digestion might slow down or even completely stop. At the same time, stress can leave the nerves in the gut overly sensitive.
(Related: Why We Undereat When We’re Stressed)
Occasional heartburn isn’t a problem, but experiences of frequent indigestion should push you to prioritize a healthier lifestyle. According to a recent study of 9,000 heartburn patients, following a five-step health plan—maintaining a sensible body weight, eating well, exercising, not smoking and limiting coffee, tea and carbonated beverages—can decrease symptoms by 40 per cent. Andrews also tells his patients to avoid eating close to bedtime: “If you lie down when your stomach is full, it’s much easier for things to come up.”
Over-the-counter antihistamines can help by blocking the release of stomach acid, while antacid medications can temporarily relieve pain in the esophagus. But if you experience heartburn more than three times a week over a long period of time, you should visit a doctor. Frequent acid contact might scar your esophagus—and, if left untreated, increases your risk of esophageal cancer. You should also consult a doctor if, in combination with heartburn, you experience difficulty swallowing, vomiting, weight loss or anemia. A physician can prescribe stronger medication or may recommend esophageal surgery to repair or replace your damaged sphincter.
Though heartburn is currently on the rise, Andrews believes the uptick is short-term. “Once life comes back to normal, I’m optimistic about things getting better,” he says.