During the National Day holiday, dinner tables come one after another: a big family meal at noon, a reunion with old classmates at night, rich dishes and clinking glasses. The food is a delight, but plenty of people suffer at night—a burning chest, sour liquid rising into the throat, uncomfortable whether sitting or lying down. In everyday Chinese, this is called “heartburn” (烧心).
In the past two days, “holiday illness” has been trending. According to multiple media reports, emergency departments began admitting patients sickened by holiday meals as soon as the break started: some with flare-ups of old stomach problems, others rushed in overnight with acute pancreatitis after heavy food and alcohol.
This article explains heartburn clearly: what it is, how to prevent it, how to relieve it, and which warning signs you must never try to tough out.
1. Heartburn isn’t actually about the heart
Between the stomach and the esophagus there is a one-way valve—what you swallow can go down into the stomach, but stomach acid and food should not come back up. Its medical name is the lower esophageal sphincter; you don’t need to remember that, just remember “valve.”
When you indulge, trouble follows: eating too much raises the pressure in the stomach; greasy food, sweets and alcohol make the valve loosen; then if you lie down or bend over, acid and food easily surge upward and scald the lining of the esophagus—and that is how heartburn and acid reflux happen.
An occasional bout after a big meal is usually not a serious problem. But if it happens every few days, the esophagus is repeatedly bathed in acid, and that can cause real damage. It needs proper examination and proper treatment.
2. A few small things to do right before and after big meals
These are not folk remedies. They are lifestyle measures repeatedly emphasized in Chinese and international guidelines and consensus statements on gastroesophageal reflux disease. Take them one at a time; do as many as you can.
- Put your chopsticks down at “seven-tenths full.” Overeating is the number one trigger for heartburn. Start with vegetables, then try the rich dishes slowly—talk more, eat less.
- Budget your share of greasy food, sweets and alcohol. All of them loosen the valve. Pick the two dishes you crave most and just look at the rest; as for alcohol, if you can skip it, skip it.
- Don’t lie down for two to three hours after eating. Lying flat makes it easier for acid to rise. A slow walk is fine; bending to mop the floor, carrying things, or curling up on the sofa with your phone should all wait.
- Finish your last bite three hours before bed. Eat dinner earlier; as for late-night snacks, give them a pass this holiday.
- If heartburn hits at night, raise the head of the bed by 15 to 20 centimeters. Note: raise the whole head of the bed—stacking a couple of extra pillows does not work, because lifting only your head bends the waist and abdomen and creates pressure there.
- Loosen your belt a notch; don’t cinch your waist. The tighter your abdomen is compressed, the more easily stomach contents are pushed upward.
3. If heartburn has already started, do this
Sit upright first; do not lie down. Loosen your belt, sip some warm water slowly, and make yourself more comfortable.
Never try to force vomiting by gagging yourself. Acid passing through the esophagus a second time is a second injury, and violent vomiting carries a risk of tearing the esophagus.
When it comes to medication, follow your doctor. Take what your doctor has prescribed as directed; do not buy “stomach medicine” you have never used and take it long-term just because someone recommended it—long-term self-medication with this type of drug carries risks, and whether to use it and for how long is a decision for a doctor.
If heartburn keeps coming back, get it checked once. If you have heartburn more than two or three times a week, or it drags on for weeks without resolving, don’t tough it out and don’t just keep buying medicine. See a gastroenterologist once. If a gastroscopy is advised, have it—sedated gastroscopy is now very well established, and you sleep through it.
4. The four most common misconceptions at the dinner table
Misconception one: “Heartburn means something is wrong with my heart.”
Most heartburn is acid reflux, not the heart. But after age 50, chest discomfort should not be self-diagnosed—see section five below for how to tell the difference. It is the most important part of this article.
Misconception two: “A little vinegar, soda water or strong tea cuts the grease and aids digestion.”
Vinegar does not aid digestion; carbonated drinks cause bloating and burping and push the stomach upward; strong tea and coffee actually loosen the valve further. For cutting grease, plain water is the most reliable.
Misconception three: “A hundred steps after a meal—drop the chopsticks and go, the faster the better.”
A leisurely stroll after eating is good; but brisk walking, group dancing or bending over to work right away can make reflux worse. Waiting twenty or thirty minutes before moving is safer.
Misconception four: “It’s an old problem, I’ll just tough it out.”
An occasional episode can simply be watched. But repeated reflux that is neither examined nor treated will damage the esophagus. More importantly, some dangerous diseases disguise themselves as “an upset stomach.”
5. These warning signs are not to be endured
First rule: when your chest feels wrong, think of the heart first.
If the chest feels squeezed, dull or tight, with cold sweats, pain radiating to the left shoulder, left arm, jaw or back, or lasting ten to twenty minutes without easing—never mind whether it feels like heartburn. Treat it as a heart problem: call 120 immediately, rest where you are and wait for the ambulance. Do not drive or ride a bike to the hospital yourself.
In older people, heart attacks often do not follow the usual script: it may be only a tight throat, stomach discomfort, weakness or nausea, without severe pain. If you cannot tell heartburn from a heart problem, act on the worst possibility—this is not overreacting; it is a lifesaving habit.
In these situations, get to a hospital promptly:
🚩 Vomiting blood, or black, tar-like stools—possible gastrointestinal bleeding;
🚩 Food increasingly getting stuck, or pain when swallowing—the esophagus needs checking;
🚩 Losing weight without trying, or looking pale and anemic—don’t delay, find out why;
🚩 Severe upper abdominal pain spreading to the back, with repeated vomiting that does not ease—especially after heavy food and alcohol, be alert to acute pancreatitis and don’t wait until the next day.
In this one situation, schedule a gastroscopy: heartburn and reflux that persist for weeks, or that return as soon as you stop medication. Get it checked once for clarity and peace of mind.
During the holidays, being able to eat well is a blessing; eating wisely is a skill. Heartburn is not a big deal—just remember three things: don’t tough it out, don’t take medicine at random, don’t guess at the disease.
Let’s talk in the comments: which of these is your family most guilty of at gatherings? (“Eating until you can’t stand,” “lying down right after dinner,” “alcohol at every meal”… feel free to match yourselves.) And feel free to forward this to the person who always organizes the family dinner table.
— Shengxin, explaining health matters one at a time —
This article is health education and does not constitute medical advice. If you feel unwell, please seek medical attention promptly and follow your doctor’s instructions for diagnosis and treatment.