<<Disclaimer: Verify this information before applying it to your situation.>>

Since so many of us have this problem, I thought the heartburn process
should be covered well since I do have some new information:

Celiacs tend to have more than their share of heartburn because we have so
many episodes of gas (gas pressure is also responsible for a lot of the
sharp gut pain after a gluten attack): the pressure from the gas pushes
acid from the stomach back up into the esophagus causing that familiar old
burning feeling below our throat. When it gets worse it can cause chest
pain, especially after some exertion or after going to bed which allows the
acid to flow back up into the esophagus again.

But chest pain tends to come at their worst after ingesting something that
relaxes the sphincter at the bottom of the esophagus. When we ingest
alcohol, heavy fats or peppermint it relaxes this sphincter which allows
acid to flow back up into the esophagus. The pain from this acid then
causes the sphincter to spasm and cramp causing a pain similar to that you
get when any muscle cramps, and it can mimic the pain of a heart attack
quite well, even down to pains in the left jaw and arm (this latter is due
to pressure on the area where the esophagus passes through the diaphram;
there is a sympathetic nerves going from the diaphram to the heart). If,
however, you have trouble swallowing or food lodges in your throat, you
should see a doctor. Also, if you experience nausea or vomiting, or pass
black stools, as well as dizziness, shortness of breath, sweating or rapid
heartbeat you should probably see a doctor. Many people who have the chest
pain ignore heart attacks because they think they are just having another
episode of bad reflux.

If your doc prescribes a proton pump inhibitor like Prilosec or Prevacid
(typically and best for 20 weeks), a recent study reported on MedScape
demonstrated that healing took place much better and more rapidly if the
patient also used an acid inhibitor such as Zantac (which is GF and lactose
free) when they felt some heartburn in spite of the prescription drug. O/C
Zantac pills are 75 milligrams while prescription versions are 150 or 300
mg. So I don't hesitate to take two of the O/C pills when needed.

It may be a bad idea to take any antacid, like Tums or Malox, habitually
without simultaneously taking an acid inhibitor also. Antacids only dilute
the acid in the stomach causing  you to secrete more acid, which is called
a "rebound effect." You don't tend to have this problem so much with the
acid inhibitors. Prilosec and Prevacid do not cause rebound unless they are
taken for more than the recommended 20 weeks, which should only be done by
a doc who knows what he's doing (and the two don't necessarily go together :)

Of course, if  you're one of the lucky ones who can still drink milk that
helps a lot for this problem.

The worst offenders (in descending order) for acid reflux in general are:
alcohol, heavy fats, peppermint, decaf, coffee, tomatoes and other high
acid foods, spices. And of course, last but not least is being a glutton,
which many have mistaken for gluten, such as the Skamania Lodge on the
Columbia River, who wrote to swear to me that they could definitely prepare
"glutton free food"; which gave me a lot of confidence in them :)
Overeating also relaxes the sphincter, pushes acid back up the esophagus,
and can cause all the worst problems of acid reflux. -vance