Question:

What causes heartburn? Are there specific foods that can cause it? What is the best way to avoid heartburn?

Answered by Darby Luckey, DO

Heartburn is a burning or uncomfortable sensation usually felt at the lower end of the esophagus and top of the abdomen, known as the epigastric area. It is caused by stomach acid, food products or other items we have taken orally backing up into the esophagus and causing irritation.

Other symptoms can include:

• Acidic taste coming from the back of your throat
• Difficulty swallowing
• Congestion
• Chronic cough

Certain foods or substances can cause or worsen heartburn. These include:

• Spicy foods
• Greasy foods
• Acidic foods (like tomatoes or citrus fruits)
• Alcohol
• Tobacco
• Some medications, like ibuprofen

Weight plays an important role in heartburn. Being overweight or obese increases your risk of heartburn. Extra weight in the abdominal area can force stomach contents back into the esophagus. Women who usually do not have heartburn may experience it during pregnancy due to weight gain, increased abdominal pressure and hormonal changes.

The best ways to avoid or reverse heartburn are to:

1. Avoid overeating. Your stomach is the size of a fist. If you are eating more than the size of your fist in one sitting, the chance you’ll experience heartburn increases.
2. Maintain a healthy weight. Aim for a normal body mass index.
3. Avoid alcohol, tobacco and foods you know are triggers.
4. Eat a whole food, plant-based diet. Reduce your intake of meat and other inflammatory foods.
5. Avoid over-the-counter medications like ibuprofen. Nonsteroidal anti-inflammatory drugs, or NSAIDs, are infamous for causing heartburn.
6. Don’t eat too late at night. Have a reasonably timed dinner, then avoid foods and drinks until bedtime. It’s important to have about a 12-hour fasting window to allow your body to digest, empty your stomach and metabolically prepare for the next day.

If you are experiencing heartburn regularly, even if it is mild, it is worthwhile to consult with a provider. Having heartburn occasionally, or even once a week, does not necessarily indicate a worrying condition. However, it doesn’t hurt to have it checked. If you have heartburn more than that, you may need to be evaluated for underlying conditions, such as gastroesophageal reflux disease, or GERD, Barrett’s esophagus or erosive esophagitis, which can lead to cancer.

While we have medications to treat heartburn, both over the counter and prescribed, it’s important to make as many lifestyle changes as you can to help reduce heartburn. It’s tempting to just take a pill, but there are long-term consequences to all the actions we take for our health, both good and bad. Acid-reducing medications are no exception. Lifestyle changes like losing weight, not overeating and avoiding triggering foods can reduce or eliminate heartburn and help you stay healthy.