What causes heartburn?

Published December 4, 2014

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Heartburn, or reflux, occurs when the contents of the stomach back up into the oesphagus and cause a burning sensation in the upper abdomen or behind the breastbone. Normally when food or liquid travels through the oesophagus and into the stomach, a small band of muscle called the lower oesphageal sphincter (LOS) that sits between the oesphagus and stomach, closes. If this band doesn’t close tightly enough, the contents of the stomach, including stomach acid, can squeeze up through the sphincter and into the oesphagus causing irritation and heartburn.

Healthy people can experience heartburn from time to time,1 which may be triggered by various diet and lifestyle factors. When heartburn happens on a regular basis, it may be caused by an underlying health condition and needs to be investigated by a healthcare professional.

Causes of occasional heartburn include:

  • Overeating1
  • Eating a large meal followed by doing some kind of physical activity such as bending or lifting.1
  • Too much alcohol or caffeine.1 Excess alcohol, coffee and other caffeinated beverages can cause heartburn in some people. This is because they relax or weaken the LOS,2 which can cause stomach contents to rise up into the oesophagus, resulting in the tell‐tale burning sensation.
  • Chocolate and meals high in fat, which can also relax the LOS2
  • Tomatoes and citrus fruits, which can contribute to the discomfort of heartburn.3
  • Peppermint and spearmint ‐ Although peppermint is recommended for various digestive complaints, it can affect the LOS and lead to heartburn in susceptible people2
  • Cigarette smoking, which relaxes the LOS and stimulates acid production.3
  • Stress – Stress and a lack of sleep can increase acid production and lead to heartburn.3
  • Increased abdominal pressure – being overweight or pregnant can cause heartburn symptoms, as any extra pressure on the stomach can force the stomach contents up into the oesophagus1

How can I avoid occasional heartburn?

There are many things you can do to avoid heartburn including:

  • Eating smaller, more frequent meals.
  • Limiting foods that relax or weaken your LOS. Food triggers vary between individuals.
  • Giving up smoking
  • Moderating alcohol and caffeine consumption
  • Steering clear of carbonated beverages as burps of gas can force the LOS open and promote reflux.2
  • Wearing comfortable clothing when eating and avoiding tight‐fitting garments, as increased pressure on the abdomen can open the oesophageal sphincter.2
  • Staying upright after meals. Food inside the stomach is kept there by the force of gravity, so it’s important not to lie down after a big meal1
  • Trying not to increase stomach pressure through bending or lifting after eating.1
  • Eating dinner at least three to four hours before going to bed.2
  • Losing weight if necessary or maintaining a healthy weight.
  • Getting enough sleep and minimizing stress through exercise and stress‐management techniques such as deep breathing, yoga, meditation or tai chi.

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