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13 Things That Might Trigger Heartburn

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woman eating burger

When you get heartburn, it’s like you’ve suddenly gotten your private investigator license: Your instinct is to retrace your steps, examining what you ate, drank, and did over the last few hours. That burning sensation in your chest clearly came from somewhere—and you’re going to figure out the cause.

Smart strategy, says Ahmad Kamal, M.D., associate chief of gastroenterology and vice-chair of internal medicine at Santa Clara Valley Medical Center. If you get heartburn, “you need to ask yourself, ‘What did I eat to precipitate that?’” Dr. Kamal says. Once you determine the culprit (it helps to keep a food journal), you don’t have to cut it out of your life forever. “For most people, you don’t have to eliminate, just go to moderation.”

A quick anatomy lesson: There’s a muscle that sits between your esophagus (you might know it as the “food pipe”) and stomach, which loosens when you eat or drink in order to let food down. At all other times, it stays contracted, keeping everything you’ve consumed in the stomach, where it can be digested. Heartburn occurs when the muscle relaxes at the wrong time, allowing acid from stomach to come up the esophagus. Once you identify what might be causing your heartburn, you can take steps to avoid it from happening again, whether it’s avoiding the reflux-causing culprit or taking a medication like Nexium 24HR (once a day for 14 days) if you get heartburn two or more days a week. To help you get started on solving your burning mystery, here are some reasons you may get heartburn.

woman with heartburn

Caffeine: Caffeine is known to weaken the muscle that keeps acid where it belongs, Dr. Kamal says. He points out that everybody is different: You might get heartburn after one cup of coffee, but your partner may be able to drink three or four without pain. Oh, and if you decaf drinkers think you’re off the hook on this one, think again. Even decaf teas and coffees contain small amounts of caffeine. Tomorrow, try cutting back on your usual drink (by, say, one mug) and see if it makes a difference.

Citrus: Fruit is healthy! Fruit is delicious! But too many citrus fruits specifically can bring way too much acid into your system, especially on an empty stomach. Eat in moderation, or make some other fruits your new faves. More alkaline fruits like bananas and melons are safer bets.

Tomatoes: Tomatoes are another acidic fruit, and a notorious heartburn culprit. If you get heartburn after pizza, pasta with tomato sauce, or even a caprese salad, you might consider dialing back on portions or frequency and see how you feel.

Chocolate: Like caffeine and acidic fruits, chocolate is a very common cause of heartburn, Dr. Kamal says. “It is somewhat dose-related,” he explains. “If you have a little bit, it’s no big deal; if it’s a moderate amount, you may have a little heartburn; and if you have a lot of chocolate, you may have a lot of heartburn.”

Fatty foods: Ever get a burning sensation in your chest after having an overly rich or greasy meal? Sad to say these tasty foods can be a major heartburn trigger—they tend to decrease pressure in your lower esophageal sphincter, which means the stomach takes longer to empty, putting you at higher risk of reflux. Go for high-protein, low-fat foods, and opt for lean meats and healthy fats.

A big meal: Of course, “big” is relative. For some, this could mean Thanksgiving-style over-fullness; for others, heartburn can be triggered by a third slice of pizza. “It’s different for different people,” Dr. Kamal says. “Most people are able to indulge once in a while and be fine, but others are sensitive.” He suggests paying attention to your body and handling your portions accordingly. “You can decide for yourself, ‘Is this something I am willing to [physically] pay for, or should I just avoid that third slice?’” he says.

Extra weight: Dr. Kamal says extra flesh puts pressure on the stomach, which can push acid up into the esophagus. “Plus, we suspect that hormonal issues related to obesity can cause heartburn,” he says. It’s a possible double-whammy, but one that should go away as you lose weight. “Losing even 10 pounds can help reduce heartburn,” Dr. Kamal says. 

woman late night snacking

Midnight snacks: Dr. Kamal recommends not eating and drinking beginning three hours before bed. “Generally anything inside the stomach will stimulate it to produce acid,” he says. “We want the stomach to go to sleep when you go to sleep.” It’s also important to maintain good posture during and after your meal—in fact, taking a walk after eating can help your digestion.

Sleeping totally flat: This is a big one, Dr. Kamal says. “When you lie down at night, the acid in your stomach doesn’t have gravity pulling it down,” he explains. “And it’s common to get heartburn.” Lying on an angle helps gravity do some work, he says. “For people with nighttime heartburn, we recommend people put bed blocks under the head of the bed itself. The idea is that the esophagus is above the level of stomach.” You can buy bed blocks or wedges at home goods stores—look for blocks that are 6 to 9 inches, and put them under your mattress or the legs of the bed on the side where your head goes.

Too-tight pants: Yes, you can get those jeans zipped. But if they are leaving a mark on your skin when you take them off, they could be squeezing your stomach—and causing acids to burble up into your esophagus. “If you see impression of your clothing or an elastic band on your skin, your clothes are too tight,” Dr. Kamal says. His advice: “Wear your clothes lower, with the waistband over your hips rather than over [the] belly. It helps reduce the pressure on your stomach and will reduce heartburn.”

Squats and crunches: “Bending over can precipitate heartburn,” Dr. Kamal says. “Exercises where you’re bending over or putting pressure on abdomen, like squats or sit-ups, can lead to heartburn.” But don’t hit the couch just yet. Dr. Kamal emphasizes that moderate exercise can be beneficial in combating heartburn. So if you do find that certain moves are making your burn—and not in a good way—simply replace them with other activities. 

Pregnancy: As the baby grows and your uterus expands, the pressure on your stomach can cause heartburn, Dr. Kamal says. He notes that there may also be hormonal factors at work.

Smoking: Of all the causes of heartburn, smoking cigarettes is the one that doctors know for a fact has a cumulative effect. “Nicotine and tar are both harmful for heartburn,” Dr. Kamal says. “Smoking is a big cause of weakening the muscle between the esophagus and the stomach, and that can have long-term effect.” So if you need another reason to quit, here it is.

With a few exceptions (like cigarettes), Dr. Kamal says, heartburn is situational: If you stop whatever triggers your symptoms, the symptoms should go away. “Some people make that tradeoff of indulging at times,” he says. Either way, “all these things are reversible with the exception of smoking.” His advice for managing—and eliminating—heartburn: “Be moderate in everything you do, pay attention to your eating, your body mechanics, and your sleep habits, and your heartburn should get better.” 

Find other great health and wellness stories at BHG.com/Strive.