Heartburn causes

What are the causes of heartburn?

Nutritional Practitioner, BA (Hons), DN, DNT (Distinction)
Ask Ali

An introduction to the causes of heartburn

A circular muscle called the lower oesophageal sphincter (LOS) joins your oesophagus to the stomach. This relaxes in order to let food move into your stomach shortly after eating but quickly closes again afterwards. This prevents the contents of your stomach travelling back up into your oesophagus.

If your LOS isn’t functioning properly this can give rise to heartburn. The lining of your stomach is equipped with a protective mucous layer which acts as a barrier against the strongly acidic internal environment. Your oesophagus isn’t quite so fortunate and doesn’t have the same protective mechanism in place. If your gastric juices, rich in strongly acidic hydrochloric acid, make contact with your oesophagus you are likely to experience heartburn.

There are various factors that can cause your LOS to open when it isn’t supposed to. We discuss these in the following section.

What you eat

Food is very often demonised when it comes to heartburn. Food isn’t always the primary cause but very often one of a few contributing factors.

Certain foods are more likely to give rise to heartburn though, for example, foods high in fat can delay gastric emptying. This means food sits in the stomach longer and can more easily contribute to heartburn; especially if you are taking part in something fairly energetic soon afterwards!

Food rich in dense animal protein, such as red meat, are particularly ‘acid-producing’ as stomach acid is required to activate the enzyme pepsin to break protein down.

Eating too much food at once is also a risk factor as it increases the internal pressure in the stomach which can cause the LOS to open. Eat smaller portions more often to lessen the load on your stomach.

How you eat

Have you ever considered how you eat as opposed to what you eat in terms of the effects it has on your digestive system? Now is the time to as we highlight some eating habits which may finally allow your stomach to function as it should.

  • Chew your food! – Chewing your food properly seems obvious but many people don’t manage it and it can really affect your digestion. The smaller the surface area available to your gastric juices (bigger chunks) the more likely you are to suffer from indigestion and heartburn as your gastric juices struggle to break the contents of your stomach down. Read our blog on the importance of chewing to learn more
  • Water – It is important to drink water throughout the day but try to refrain from doing so at meal times. If you drink lots of liquid together with your meals you risk diluting your gastric juices. Avoid drinking water 20 minutes before a meal and up to an hour after. Weak stomach acid can cause a host of problems, heartburn being one of them
  • Posture control – Your posture is important for everyday life but also for your stomach. If you are hunched over your stomach becomes squashed and your gastric secretions are unable to flow freely. Sit up straight at meal times! Lying down soon after can also make your symptoms worse so  make sure you eat your evening meal several hours before going to bed.

Put these new habits into practice and your digestion should run much smoother.

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Lifestyle factors should also be taken into considerations as they can have a significant impact on your digestive system.  Many of the following factors can give rise to indigestion which in most cases is a cause of heartburn

  • Stressstress can affect the functioning of your digestive system. Over time, stress can diminish your levels of stomach acid which surprisingly is a common cause of acid reflux and heartburn. Manage your stress effectively and your stomach could feel the benefits
  • Caffeine – caffeine can irritate the lining of your stomach and is classed as ‘acid-producing’. Too much or too little acid can affect the functioning of the LOS. Try replacing your daily cups of tea and coffee with a coffee alternative or a calming herbal tea such as Chamomile
  • Alcohol – alcohol is also acid-producing and an irritant which can aggravate your tum and give rise to heartburn.  Limit your intake, especially before bed as this can also make your symptoms worse as you lie down flat
  • Exercise – exercise is recommended for many reasons but certain types may actually aggravate heartburn. Read our blog on exercise and heartburn to determine how you can enjoy heartburn-free workouts
  • Smoking – smoking affects the functioning of the LOS and causes it to relax, and this can up your instances of heartburn
  • Weight gain – as your weight increases so does your risk of heartburn. Additional abdominal weight is thought to increase the pressure in your stomach which can cause the LOS to leak.

Health conditions and medications

It is important to note that certain health conditions and circumstances can give rise to heartburn so these are something to be aware of.

  • Indigestion – as previously mentioned, indigestion is very often the root cause of heartburn and the causes, symptoms and treatments are therefore very similar for both. Click on the above links to go to our indigestion pages
  • Stomach acid – stomach acid has important functions both in the stomach and further on in the digestive tract. Therefore an imbalance can be problematic. Too much stomach acid or too little (not so well recognised) can both give rise to heartburn. Click the link to learn more about this issue and how you can tackle it
  • Pregnancyheartburn is commonly experienced during pregnancy. A combination of hormones and your expanding womb change the pressure in your stomach and your LOS can leak as a result
  • Others – recurrent or severe heartburn is not something to be ignored. Hiatus hernia, for example, occurs when part of the stomach squeezes through an opening (the hiatus) in the diaphragm. If you experience heartburn often and it doesn’t seem to be linked to many of the obvious causes outlined above we would advise you pay a visit to your GP.

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