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Heartburn 101

Got a burning, burping feeling in your chest? Learn what causes it, how you can manage it, and when to see your doctor.
By
WebMD Magazine - Feature

There was a time when it didn’t take much to set off Sara Perlman-Smith’s heartburn. Spicy foods, alcohol, even a foul mood could send a burning wave rushing up her throat. "I could feel the acid in my esophagus," she recalls. "It was just a consistent burning pain in my chest."

Then there was the constant burping. "A lot of times that would make me feel a little better," says Perlman-Smith, 38, a stay-at-home mom in Hallsville, Mo. "But a lot of the time if it was a really bad episode, I’d just be burping up acid."

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The burning and belching she describes are signs of heartburn -- a condition that’s triggered when a valve (called the lower esophageal sphincter) between your esophagus and stomach malfunctions, letting stomach acids slip out and take a wrong-way route back up your esophagus.

As the acid burns its way northward, it brings serious discomfort. "The pain radiates upward from the middle of the chest toward the neck," says Frank Marrero, MD, a staff physician in the Cleveland Clinic’s Swallowing Center. Sometimes that acid can make it all the way into your mouth.

What Triggers Heartburn?

You’d expect to feel the burn after downing a grande enchilada with extra jalapeños, but some other heartburn triggers might surprise you. Steer clear of these if you’re prone to heartburn:

  • Pain relievers. They can ease your headache, but one side effect of taking nonsteroidal anti-inflammatory drugs such as aspirin and ibuprofen is heartburn.
  • Skinny jeans. Those tight jeans might look great in the mirror, but any clothes that put the squeeze on your abdomen can worsen the burn.
  • After-dinner mints. Peppermint relaxes the muscles of the digestive system -- great if you have an upset stomach -- but it also can relax the muscle that keeps acid in your stomach. Heartburn sufferers will want to get their fresh breath elsewhere.
  • Salt. One study found that people who used extra table salt daily were 70% more likely to have heartburn. It’s another reason (along with high blood pressure) to pass on the salt.
  • Lighting up. If cancer, heart disease, lung disease, and wrinkles aren't enough to convince smokers to stop, here’s another: Tobacco weakens the lower esophageal sphincter.

Lifestyle Remedies for Heartburn

Heartburn can be a real pain, but you can help prevent it by making some simple changes to your routine. First, watch what you eat. Having more food in your stomach keeps more acid moving into your esophagus. Instead of gorging, graze on smaller portions of food throughout the day. Avoid the most notorious heartburn triggers: chocolate, caffeine, citrus fruits, and tomatoes.

Watch the fat in your meals, too, because both consuming high-fat foods and being overweight can cause heartburn. "If you have extra weight in your belly, basically what you’re doing is putting pressure on the stomach," Marrero says. That added pressure pushes more stomach acid up into your esophagus.

Nighttime can be a real nightmare for heartburn sufferers. Approximately one in four Americans has heartburn attacks at night. When you’re lying in bed, gravity works against you, keeping that corrosive acid stuck in your esophagus. You might have heard the advice to raise the head of your bed 6 to 9 inches, which can help. But Marrero says it’s not always practical if you share a bed. He says a better solution is to stop eating two to three hours before bedtime so that you go to sleep with an empty stomach.

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