Heartburn is a common ailment that is experienced by millions of people every day. Indeed, almost everyone will get heartburn at some point in their lives. For most people, it is a mild annoyance that crops up after eating something spicy, fatty, or acidic and then goes away on its own. For others, though, it can become a regular occurrence that decreases one’s quality of life and the pleasures associated with eating. While heartburn isn’t always caused by specific diet choices, it is usually a primary contributing factor; to reduce the chances of getting heartburn, there are some foods and beverages that are best to avoid.
What is Heartburn?
Heartburn is a group of symptoms rather than a full medical condition, and the term refers to the burning sensation that can sometimes be felt in the center of the chest or even radiating out to the throat or upper arms. Heartburn is associated with a variety of gastrointestinal problems such as acid reflux, indigestion, or gastroesophageal reflux disease (GERD). These associations are so strong, in fact, that the terms acid reflux and heartburn and indigestion are sometimes used interchangeably.
The main mechanism of heartburn is a disruption to the opening and closing of the lower esophageal sphincter (LES), a ring of muscle around the base of the esophagus that controls the passage of food into the stomach after it has been swallowed. The LES opens to allow food into the stomach cavity and then closes again to prevent the stomach contents from reentering the esophagus during digestion. The most active part of digestion is called peristalsis, and it involves contractions of the muscles surrounding the stomach that cause the contents to slosh around in a vigorous way.
There are times, however, when the LES does not function properly and closes incompletely or not at all. When this happens, the violent contractions of the stomach can cause acidic digestive juices to splash up into the esophagus. One of the most abrasive elements of digestive juices is hydrochloric acid, and it is its contact with the inner mucosal lining of the esophagus that causes the burning sensation of heartburn. The spread of the discomfort beyond the center of the chest is primarily based on how far up the esophagus the regurgitated stomach acid goes.
While heartburn is the symptom that is experienced, the actual act of acid backing up into the esophagus is what is known as acid reflux. In addition to the familiar burning sensation of heartburn, acid reflux can cause bad breath, widespread chest pain, or even problems breathing. When acid reflux continues unabated and is considered chronic, the condition becomes known as GERD. GERD is a more serious condition that can have long term effects and lead to esophagitis, asthma, sinusitis, or Barrett’s Esophagus (precancerous mutation of the esophageal lining).
Diet Changes for Heartburn Prevention
Many people already know some of their heartburn triggers, but they choose to partake from time to time because enjoying a favorite food is worth a little heartburn. But as noted above, ignoring chronic heartburn can be detrimental to one’s health. The following are some foods and beverages that should either be avoided or embraced if you want to prevent heartburn:
Foods to Avoid
Most of the trigger foods that you should avoid are problematic because they disrupt the digestive process by relaxing the lower esophageal sphincter and slowing down the process in general. In these circumstances, food sits in the stomach longer and has more opportunity to splash up into the esophagus. The foods that are most likely to have this effect are high in fat, salt, or spice.
- fried foods
- potato chips
- spices like chili powder and pepper
- bacon, sausage, and other fatty meats
- citrus fruits
- tomato sauce (and foods containing tomato sauce)
- carbonated beverages
Foods to Embrace
Even as you avoid some foods, there are others that can actually help prevent LES relaxation and disruption to the digestive process. One main category of preventative foods is items that are high in fiber; in addition to a variety of other health benefits, fiber can help you feel more full and therefore be less likely to overeat (another contributor of heartburn). Another category is high pH alkaline foods that can neutralize the effects of excess stomach acid. Foods that have a high water content can also be effective at this.
- whole grains like brown rice or whole-grain breads
- root veggies like sweet potatoes or beets
- green veggies like broccoli or green beans
- herbal tea
- broth-based soups
An important overarching principle in heartburn prevention (and with one’s diet in general) is to make food choices in moderation. You may not realistically be willing to avoid fried foods for your entire life, but if you eat in moderation as part of smaller meals, you may be able to mostly avoid getting heartburn. Additionally, doctors recommend that even if you do end up eating such foods, it’s best to avoid eating them late at night. This is because stomach acid can more easily splash into the esophagus while you are laying down; this is also why people tend to get heartburn more often at night.
Heartburn Treatment and Home Remedies
For most people, making some of these diet changes can make a significant difference in the frequency and intensity of heartburn and other acid reflux symptoms. When the condition is chronic, however, or the symptoms of GERD begin to appear, it may require medication to really find relief. Many over-the-counter options are available, including antacids to neutralize stomach acid or proton pump inhibitors to reduce acid production. If over-the-counter treatments turn out to be ineffective, a doctor may turn to further testing or prescription medication.
In some cases, medication may not be sufficient on its own to really get the relief you’re looking for. Beyond avoiding trigger foods and incorporating more beneficial foods, there are also some lifestyle changes that can help lessen or prevent heartburn:
- Weight management: carrying excess weight around the midsection can actually cause pressure on the stomach and make acid reflux more likely. Maintaining a healthy weight can relieve this pressure.
- Loose clothing: in a similar way as having excess weight, tight clothing can cause constriction of the abdominal cavity. Wearing clothes that are more loose-fitting can thus help you avoid heartburn.
- Meal timing: eating smaller meals at normal intervals throughout the day can help you avoid the pitfalls of overeating and eating late at night.
- Sleep practices: you shouldn’t eat less than three hours before you go to sleep, but even then your sleeping position can be a problem. By elevating the head of your bed so that your body is at an incline from the waist up, you can avoid the kind of acid reflux that happens when you’re totally horizontal.
- No smoking or drinking: both smoking and drinking can relax the lower esophageal sphincter and irritate the esophagus, so it is highly recommended that you avoid both if you have ongoing problems with heartburn.
When to See a Gastroenterologist
If you continue to struggle with heartburn even after making diet changes and trying other remedies, it’s a good idea to consult an expert in digestive health care. At Cary Gastro, our doctors and staff are passionate about getting you excellent health care and increasing your quality of life. Whether you have questions about heartburn or any other questions related to gastroenterology, please contact us to request an appointment.