Heartburn is an occasional unwelcome guest for most of us. Its most common telltale sign is a burning pain behind the breastbone. The usual cause is the backing up (reflux) of stomach acid into the lower esophagus, inflaming its sensitive lining. If heartburn progresses from occasional to chronic—symptoms that occur more than once a week for months—it could mean a more serious condition known as gastroesophageal reflux disease (GERD). The condition affects up to 1 in 5 people worldwide.
Whether you want to prevent reflux or soothe its painful symptoms, start by addressing the underlying causes. Certain foods can trigger heartburn, as can behaviors like eating big meals—especially too close to bedtime.
What Causes Reflux? Ground zero for heartburn is the lower esophageal sphincter (LES), the muscular passageway between the lower esophagus and the stomach. Normally, the LES maintains a tight seal after allowing the food you swallow to pass into the stomach. However, weakening of the LES can cause acidic stomach contents to back up and irritate the wall of the esophagus.
Heartburn Triggers: Foods that can cause or worsen symptoms of heartburn fall into two categories:
-Relaxers: These foods can lower the pressure between the esophagus and stomach or relax the LES, making it easier for stomach acid to back up. Potential triggers include caffeine, chocolate, alcohol, peppermint and fatty meals.
-Irritants: These foods can aggravate existing irritation of the esophagus caused by reflux. Potential irritants include spicy or acidic foods, such as orange or tomato juice and carbonated beverages.
A recent review of research in Current Opinion in Gastroenterology found mixed or conflicting evidence for some suspected dietary triggers of heartburn, such as fatty foods, coffee and chocolate. However, evidence for other triggers, such as alcohol and acidic beverages, is fairly solid.
But it’s not necessary to ban all possible food triggers across the board. Instead, pay attention to what foods seem to trigger your symptoms, avoid them for a while and see if it makes a difference. “There are really no absolute triggers,” says Harmony Allison, MD, a gastroenterologist at Tufts Medical Center. “Certain ones may be triggers for you or they may not be.”
Lifestyle Matters, Too: Certain behaviors can cause or worsen heartburn symptoms. The main ones include being overweight, eating to the point where you feel stuffed, lying down after eating a large meal or eating the majority of your food late at night.
New or worsening GERD can be a warning that you should think more broadly about your health habits. “I think that we sometimes overplay dietary triggers,” Allison says. “Reflux can actually be the body’s way of telling you that it’s time to start taking better care of yourself. You may need to lose weight and make healthier choices in your diet, like eating smaller portions and meals and drinking alcohol in moderation.”
Such changes could also reduce your risks of heart disease, diabetes and other chronic conditions—a win for your overall health as well as your digestive tract.
Is It GERD?
The most common symptom of gastroesophageal reflux disease (GERD) is heartburn, a painful, burning feeling in the middle of the chest, behind the breastbone. Other symptoms of GERD include:
-Regurgitation of gastric acid or sour contents intothe mouth
-Difficult and/or painful swallowing
-Chronic cough, caused by acid refluxing up andgetting into the lungs
-Chest pain
-Hoarseness in the morning
-Bad breath
-Nausea or vomiting
-A feeling like something is stuck in your throat
Image © solar22 | Getty Images
In addition to identifying food triggers, try these steps to prevent backing up of stomach acid:
-Achieve and maintain a healthy body weight.
-Eat your meals more slowly.
-Don’t lie down after meals.
-Don’t consume the majority of your food as
one large meal.
-Don’t eat within several hours before bedtime.
-Don’t exercise immediately after meals.
-When sleeping, prop up your torso with pillows or a bed wedge.
-Rule out heartburn caused by medications or dietary supplements. Some supplements and drugs can cause reflux or inflammation of the esophagus. If you start taking a medication and experience heartburn, talk to your doctor.