Eight Reasons Why You Have Heartburn, According to Physicians
If you, like over 60 million Americans, suffer from frequent heartburn, you know how uncomfortable the condition can be. The burning sensation in your chest gets worse after you eat a meal, lie down, or bend over during the evening hours, and the feeling can make just about any activity less enjoyable. Generally, the ailment is assumed to be caused by an overproduction of stomach acid, which "spills" upward and into the esophagus; eating too much or too quickly can also be to blame, notes Dr. Tricia Pingel, N.M.D., a naturopathic physician. "While treating symptoms by popping an antacid or changing your diet or eating habits may offer some temporary relief, they often don't address the real issue at hand: stress-induced low stomach acid secretion," she says.
The most important factor in determining your treatment plan is knowing the root cause. Here, doctors share some of the most common factors that drive heartburn and explain what you can do to treat the condition.
Several foods and drinks, including chocolate, caffeine, peppermint, tomatoes, and citrus, can cause heartburn, says Dr. Benjamin Hyatt, M.D., a gastroenterologist at Middlesex Digestive Health and Endoscopy Center in Acton, Massachusetts. "The lower esophageal sphincter (LES) is a muscle that normally closes the end of the esophagus to prevent acid from coming back up, but these foods can precipitate acid passing into the esophagus by weakening the LES." He recommends limiting any general foods that commonly lead to the condition and personal triggers, as well.
Overeating, or consuming more food than your body can digest in a healthy manner, can also cause this ailment, says Dr. Hyatt, by putting too much pressure on the LES; this allows acid to make its way into the esophagus. He recommends avoiding large meals and practicing portion control to reduce your symptoms.
Heartburn is very common during pregnancy for more reasons than one. "The changes in hormones, such as increased levels of progesterone and estrogen, cause a decrease in lower sphincter pressure," says Dr. Hyatt. "Additionally, increased pressure exerted on the stomach from the growing fetus also causes acid reflux." To lessen symptoms during gestation, avoid trigger foods, eat smaller meals more frequently throughout the day, and avoid resting supine after eating. If the condition persists, discuss your treatment options with your doctor.
An estimated 36.5 percent of all U.S. adults fall under the category of "obese," per the Centers for Disease Control and Prevention (CDC), which increases their risk of a myriad of conditions including heartburn. "Excess abdominal fat puts pressure on the stomach and causes acid to travel up into the esophagus," says Dr. Hyatt. "Losing weight through diet and exercise can help reduce symptoms."
Both smoking and chewing tobacco can also increase a person's risk for heartburn. "Nicotine products weaken the lower esophageal sphincter muscle and increase stomach acid, causing reflux," explains Dr. Hyatt. He recommends avoiding the use of tobacco products for several reasons; doing so will reduced your chances of developing heart conditions and cancer.
Low Stomach Acid
While an overproduction of stomach acid may very well be at the root of some cases, Dr. Pingel has found that low stomach acid is often to blame. "Low stomach acid, or hypochlorhydria, results in a variety of symptoms—and the most common one is feeling 'full' or bloated 30 minutes or more after eating," she says. "Finding the cause of this digestive slowing is the key to determining a long-term solution."
Stress drives so many bodily conditions, including heartburn, due to its impact on the nervous system, says Dr. Pingel. "When your body is under stress, it switches focus from the parasympathetic system (the rest and digest system) to the sympathetic nervous system, which is responsible for managing acute stress," she says. "The parasympathetic nervous system signals your esophageal sphincter to close and keep the acid in your stomach." To improve unideal stomach acid levels caused by stress, she recommends eating slowly (savor your meal!) and trying relaxation techniques, such as yoga and breathing exercises.
Although exercise can help acid reflux through weight loss and stress reduction, Dr. Hyatt notes that intense movement can actually exacerbate the issue. "Vigorous exercise, such as running or high intensity interval training, can increase acid reflux due to reduced blood flow to the gut slowing digestion, as can gravitational forces when bending or stooping during exercise," he says, and recommends avoiding eating heavy meals before you exercise to reduce heartburn symptoms during workouts.