Heartburn is that burning sensation in your chest or throat that’s caused by acid rising up from your stomach. It’s a common symptom of the condition called gastroesophageal reflux disease or GERD, which is also called acid reflux.
When you talk to your doctor about heartburn, the doctor will first ask you about your diet. That’s because eating certain foods is one of the main causes of heartburn. Coffee (including decaf), soda, tomatoes, alcohol, and chocolate are often heartburn triggers.
For most people, heartburn is a treatable symptom. Frequent heartburn may indicate acid reflux or gastroesophageal reflux disease, also known as GERD. When treatment doesn't work and heartburn is severe despite lifestyle changes, surgery may be an option. It may also be an option if GERD causes other medical problems. Minimally invasive procedures using endoscopy are also available to treat acid reflux.
But eliminating foods that cause heartburn problems may not be enough. Many other factors can also play a role in triggering heartburn and causing GERD.
Besides foods, what are other causes of heartburn?
Other heartburn triggers include:
Overeating. Overeating can trigger heartburn. That’s because the stomach remains distended when there are large quantities of food in it. There is a muscle located between your esophagus and your stomach. Your esophagus is a tube that lets food pass from your mouth to your stomach, and the muscle between it and your stomach is called the lower esophageal sphincter or LES. The more your stomach stays distended, the more likely the LES won't close properly. When it doesn’t close, It can’t prevent food and stomach juices from rising back up into the esophagus.
Eating habits. Eating too rapidly can be a heartburn trigger. So can eating while lying down or eating too close to bedtime. It helps to not eat during the two or three hours before you go to bed.
Smoking. Smoking cigarettes is another potential cause of heartburn and GERD.
Hiatal hernia. Your diaphragm is a muscular wall that separates your stomach from your chest. It helps the LES keep stomach acid where it belongs. When the LES and the upper part of the stomach move above the diaphragm you develop a hiatal hernia. The hernia makes acid reflux, which causes heartburn, more likely. You may not even know you have a hiatal hernia. Often heartburn is the only symptom.
Obesity or overweight. Research suggests that being obese or overweight can be a trigger for heartburn and reflux disease. In one study comparing people with and people without GERD, those who had heartburn problems typically were more overweight than those without GERD.
Medication. Common medications taken for other problems, including over-the-counter and prescription drugs, can increase the likelihood of heartburn. That includes medicines used to treat asthma, high blood pressure, heart problems, arthritis or other inflammation, osteoporosis (low bone density), anxiety, insomnia, depression, pain, Parkinson's disease, muscle spasm, or cancer. Also, drugs used for hormone therapy can be a heartburn trigger.
Can exercise be a cause of heartburn?
Exercise can trigger heartburn. Sometimes that’s due to increased pressure on the abdomen, which can increase the risk of acid reflux. In one study looking at different types of exercise, weightlifters had the most heartburn and acid reflux. Runners had milder symptoms and less reflux than weightlifters. Cyclists had the least reflux.
What should I do if I’ve changed my diet and still have heartburn?
If you have ruled out food as a culprit for your heartburn and suspect one of these other factors, talk with your doctor about your options for treating and preventing heartburn.
Phil Katz, MD, president-elect, American College of Gastroenterology; clinical professor of medicine, Jefferson Medical College; chairman of gastroenterology, Albert Einstein Medical Center, Philadelphia.
Glenn Eisen, MD, MPH, professor of medicine and director of endoscopy, Oregon Health and Science University, Portland.
Peter Galier, MD, internal medicine specialist, UCLA Medical Center and Orthopaedic Hospital, Santa Monica, Calif.
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