Winter Holidays, Upset Stomachs

The holidays are cruel to our stomachs. Between October and January, our stomachs endure a lot -- Halloween candy, ladle after ladle of gravy, one-too-many flutes of champagne. We pay for that overeating, ending many holiday nights -- bloated, stomach roiling -- with a nightcap of antacid.

This year, break that holiday tradition. Enjoy the holidays, and the food, without the heartburn, upset stomach, and diarrhea or constipation. This article explains why we suffer digestive problems during the holidays, and then offers six tips to help you avoid tummy trouble.

How Holidays Make Us Sick

• Large portions. It’s simple: The more food you cram into your stomach, the more pressure on your esophageal sphincter, the muscle that keeps digested food down where it belongs. When the pressure is great enough, food and acid will back up, causing heartburn. Too much food can also slow down your whole digestive system, leading to stomachaches and constipation.
• Rich foods. Holiday foods are generally high in sugar and fat. Both cause weight gain and added over a few months, that excess weight can trigger upset stomach. Fat is an immediate problem, since it slows down the digestion and can trigger reflux.
  Other foods known to cause reflux include chocolate, coffee, alcohol, mints, and acidic foods, says Kelly A. Tappenden, PhD, RD, professor of nutrition and gastrointestinal physiology at the University of Illinois at Urbana-Champaign.
• Lack of fiber. Think of your favorite holiday food. It probably isn't bran flakes. That's part of the problem -- fiber tends to be missing from the holiday dinner table. "Low-fiber holiday foods can really stop you up and lead to constipation," says John Clarke, MD, a gastroenterologist and assistant professor at Johns Hopkins University School of Medicine in Baltimore.  
• Holiday stress. Stress -- triggered by mall shopping, cooking, cleaning, travel, and family conflict -- can cause upset stomach and heartburn. On top of that, many people cope with stress by overeating and drinking too much.

6 Tips to Prevent Heartburn and Upset Stomach During the Holidays

"The key is to be self-aware," says Tappenden. "You need to plan ahead and stay conscious of how you're eating."

1. Make trade-offs. Accept that you'll indulge during the holidays -- everybody does. Just do it strategically. Think about what you most want and plan for it.
   "If what you really love about Thanksgiving dinner is your mother's stuffing, go ahead and have a second helping," says Tappenden. "But decide not to have second helpings of the potatoes, and the pie, and everything else."
2. Compensate. If you know that you'll be eating a lot of fatty food at holiday parties this week, compensate by healthy eating at lunch. High-fiber vegetables and grains will help keep your GI tract working normally, Clarke says. "Taking a fiber supplement in anticipation can also help," says Clarke. "If you want a natural approach, flaxseed will have the same benefits."
3. Eat consciously. Starting at Halloween and ending on New Year's, you're going to be surrounded by treats. At least be aware of when you're eating them. "You don't want to dip your hand absent-mindedly into every bowl of candy you come across," says Tappenden.
4. Eat slowly. It's good advice year-round, but it's especially important now. "Eating slowly can really make a difference," says Clarke. "It will help the stomach empty better and suppress the appetite. You won't want to overeat as much if you eat slowly."
5. Limit alcohol. On its own, alcohol can irritate the GI tract and trigger heartburn. It also lowers your defenses, increasing the chances you'll make bad food choices.
6. Move. "After the pumpkin pie, don't stretch out on the couch," Tappenden tells WebMD. You're bound to get heartburn and acid reflux if you do. Instead, go out for a short walk. In general, try to keep up your regular exercise plan during the holidays -- at least as well as you can amid the chaos.

OTC Medicines for Digestive Distress

If you didn't follow all that sensible advice above -- and now find yourself bloated and miserable -- these over-the-counter (OTC) medicines might offer some relief.

• Antacids. They're what your great-grandfather took when he had heartburn on Thanksgiving eighty years ago. They might not be as powerful as some newer OTC medicines, but antacids start working almost immediately. Antacids come as liquids and tablets; brand names include Gaviscon, Maalox, Mylanta, Rolaids, and Tums.
• H2 blockers. Originally prescription medicines, H2 blockers are now available over the counter. They're good drugs for occasional heartburn, although they're most effective when taken an hour before eating, Rosh says. Examples include Axid, Pepcid, Tagamet, and Zantac.
• Proton pump inhibitors (PPIs). Three PPIs are available over-the-counter: Prevacid, Prilosec, and Zegerid. They won’t relieve heartburn right away -- they may take up to four days for full effect -- so they’re not helpful after you’ve already overindulged. PPIs are meant for people who have heartburn at least twice a week.
• Anti-diarrhea medicines. Treatments like Imodium, Kaopectate, and Pepto-Bismol can help relieve diarrhea after a night of overdoing it. While effective, these medicines can sometimes result in a new problem: constipation. Don't use these medicines if you have any signs of an infection in the intestines, like a fever or black or bloody bowel movements. In those cases, using a medicine to stop diarrhea could make the infection worse. Instead, see your health care provider.

Holiday Digestive Problems: When to Get Help

For most people, the occasional stomachache, a bout of diarrhea, or some holiday heartburn is nothing to worry about. However, if you're having ongoing symptoms, you need to see a doctor.

The worst thing you could do is ignore chronic symptoms, hoping they'll resolve in the new year on their own. That could ruin your holidays with months of pointless and preventable suffering.