Heartburn may be uncomfortable, but if it’s only occasional, it’s not generally something to worry about. If it happens more frequently, though, you may need to see your doctor to rule out gastroesophageal reflux disease (GERD), also called chronic acid reflux, or another medical problem. Feel like you fall into the latter category? Let’s take a closer look at what heartburn is, how to get rid of it, how to prevent it, and what medication options you have.
What Causes Heartburn?
Heartburn is caused by the acid in your stomach coming up into your esophagus, the tube that moves food and drink from your mouth to your stomach. Normally, the valve between your esophagus and stomach opens when you need to swallow something and then closes back up, explains Scott Gabbard, M.D., a gastroenterologist at the Cleveland Clinic in Ohio. If the valve doesn’t close completely or it opens again at a later time, acid from your stomach can come up into the esophagus, causing that burning pain known as heartburn.
Heartburn or Acid Reflux?
Heartburn itself isn’t a medical condition, but it can be the symptom of one: acid reflux, a.k.a. gastroesophageal reflux disease (GERD). Heartburn is usually the primary symptom of acid reflux but occasionally, the main symptom is nausea instead. So if you feel queasy after you eat or when you wake up in the morning and you’re not pregnant (or hung over) ask your doc about the possibility of acid reflux. In acid reflux, “there’s a ring of muscle that separates the esophagus and stomach, making a valve, and the valve should be closed,” says Dr. Gabbard. “When you swallow, the valve opens, but then it closes again. Reflux occurs when that valve opens when it’s not supposed to. Stomach contents, which generally contain a high level of acid, flow back through the valve into the esophagus.” This, in turn, leads to gas, burping and the pain of heartburn.
How to Prevent Heartburn
Knowing what causes heartburn is the first step to preventing it. “There are definitely triggers for heartburn in your diet,” says Julia Zumpano, R.D., a dietician at the Cleveland Clinic. You can work to identify those triggers by keeping track of the foods you eat: If you notice that your heartburn appears after certain meals or when you drink specific beverages, try removing them from your diet to see if the heartburn disappears. Limiting portion size is also helpful. When the stomach is too full or the food is too fatty, the esophageal valve opens and food and acid travel backwards from the stomach into the esophagus. “A study a few years back demonstrated that meals with greater than 500 calories and more than 10 to 15 grams of fat triggered the valve to open more and allow more reflux than meals that were less than 500 calories and had fewer than 10 to 15 grams of fat,” says Dr. Gabbard. Some lifestyle changes, such as losing weight (abdominal fat can push on the stomach, causing food to back up toward the esophagus) and not lying down too soon after a meal, may help prevent heartburn. Other things to avoid include exercising right after eating and wearing tight clothing, which can have a similar effect. If you tend to get heartburn during the night, try using a couple of extra pillows and elevating your upper body so that it is higher than your stomach. And if you take prescription medications, speak with your pharmacist: Heartburn is a side effect of certain drugs and if that’s the source of your troubles, your doctor may be able to prescribe you an alternative medication.
Best Over-the-Counter Meds for Heartburn
There are several over-the-counter (OTC) medications that may help relieve your heartburn. They include acid neutralizers and meds that decrease acid production. Most people are familiar with acid neutralizers, or antacids. These include brand names like Tums, Rolaids and Mylanta. According to Dr. Gabbard, antacids made with alginate, which comes from seaweed, may be the most effective. (A popular example is called Gaviscon.) “The alginate floats on top of the acid pocket in the stomach and forms a mechanical barrier,” he explains. If the antacids don’t work or don’t appeal to you, there are also two groups of drugs that decrease acid production:
Proton pump inhibitors (examples include Nexium, Prevacid, Prilosec and Zegerid)H2 blockers (Axid AR, Pepcid AC, Pepcid Complete, Tagamet HB and Zantac)
It’s important to keep in mind that these drugs shouldn’t be taken over an extended period. If you need proton pump inhibitors for longer than a couple of weeks, talk with your doctor about alternatives. As for H2 blockers, “they work in the short-term pretty well,” says Dr. Gabbard. But as your body gets used to them, they stop being effective and acid levels rise again after about a week of use.
Prescription Heartburn Medicine
If OTC meds don’t give you heartburn relief, your doctor may suggest prescription heartburn drugs. These are stronger versions of the OTC proton pump inhibitors and H2 blockers. A third prescription heartburn medication option is known as baclofen. This medication works by preventing or decreasing this ability of the esophageal valve to re-open after eating, thereby reducing how much acid can come back up.
Home remedies for heartburn
Considering how common heartburn is, perhaps it’s not surprising that there are many home remedies people use to help ease the pain. You may have heard of some of these, while others may be new to you. Many remedies incorporate the same advice as what you might do to prevent heartburn in the first place, such as elevating the head of your bed (try to prop up your entire upper body, not just your head) and loosening tight clothing. And here’s a twist: Some cases of heartburn may actually be caused by too little acid in your stomach. Without enough stomach acid, your body has trouble breaking down the food you eat, leading to a burning sensation, says Brenda Rea, M.D., R.D., a professor of medicine at Loma Linda University in California. Your fast fix: Squeeze the juice from a half lemon into a glass and drink it, Dr. Rea suggests. Not a fan of lemon juice? Some people prefer a teaspoon or two of pickle juice or apple cider vinegar instead. Whichever you choose, drink it before your meal—rather than during—for maximum effect.
What to Eat and Drink for Heartburn Relief
Let’s say you have heartburn right now—what can you do to get some relief? You could try drinking low-fat or no-fat milk, says Zumpano. This can act as an acid reducer, like OTC calcium-based antacids. Another option: Drinking herbal tea for heartburn relief, although you should steer clear of peppermint tea, which may cause heartburn rather than relieve it. And this is an odd but effective food remedy: Add a hearty dose of mustard to your meal—it may help neutralize your stomach acid, relieving that burning pain, says Zumpano. Mustard also stimulates saliva production, which acts as a lubricant and coats your esophagus, protecting it from stomach acid. (Chewing gum has a similar effect.) What about baking soda? A go-to heartburn solution for years, it can provide the relief you’re looking for. “It’s a natural remedy,” says Zumpano. “Baking soda is a base, so it offsets the acidity in your esophagus and your gut. Try a teaspoon or even a half of a teaspoon dissolved in an 8-ounce glass of water.” Don’t overdo it, though: Too much baking soda may be harmful, leading to nausea, vomiting and diarrhea. Women who are pregnant and people with chronic conditions such as heart disease, high blood pressure and kidney disease, should avoid baking soda altogether. (If you’re not sure, ask your doctor if it is safe for you.)
Foods to Avoid With Heartburn
It’s not possible to definitively say that a particular food causes heartburn—one person might be able to consume a product without any problems, while another person might have a severe reaction. But these are some of the foods that are more likely to contribute to heartburn:
Caffeine, in drinks and foodChocolateCitrus fruitsHeavy and high fat foods (French fries, potato chips, fast food, desserts)MintPeppermintSoda or anything carbonatedSpicy foodsTomato and tomato products, like tomato paste and tomato sauce
Relieve Heartburn During Pregnancy
Heartburn is a common pregnancy complaint, even among women who never had heartburn before. The most obvious cause? The baby itself. As babies grow in the uterus, they push into the stomach, which can force food and acid back up into the esophagus. An increase in pregnancy hormones can also cause problems. The job of these hormones is to relax abdominal and pelvic muscles to make delivery easier, but they can also cause muscles around the esophageal valve to relax, allowing it to open more easily. And finally, pregnant women may also have trouble digesting their food properly, adding to the heartburn risk. If you’re pregnant and struggling with heartburn, these are some of the steps, recommended by Stanford Children’s Health in California, to prevent or manage your discomfort:
Eat small meals more frequently. This gives your stomach time to digest the food.Avoid foods that may cause heartburn. Keep track of your diet to see if a particular item is leading to your pain.Sleep in an elevated position. Place blocks under the front legs of your bed (near the head), slip a wedge under the mattress or elevate your torso with pillows.
If you still have trouble with heartburn, speak with your doctor. Some heartburn medications are safe to take during pregnancy, but some aren’t. Now try these foods that are good for heartburn and acid reflux.
Sources
Scott Gabbard, M.D., gastroenterologist at the Cleveland ClinicJulia Zumpano, R.D., dietician at the Cleveland ClinicBrenda Rea, M.D., R.D., professor of medicine at Loma Linda UniversityAmerican College of Gastroenterology: “Acid Reflux”Harvard Health Publishing; Harvard Medical School: “11 Stomach-Soothing Steps for Heartburn”Mayo Clinic: “Gastroesophageal Reflux Disease (GERD)”Poison Control; National Capital Poison Center: “My Child Got Into the Baking Soda”Stanford Children’s Health: “Pregnancy and Heartburn”
