Heartburn refers to a burning sensation in your lower chest behind your breastbone (sternum). It isn’t related to your heart, but it may mimic the pain of heart attacks. You and millions all over the world may experience this sensation. It’s usually transient and easy to manage, but it may be a symptom of a more severe disease like GERD.
First, let’s know how heartburn occurs. You eat your food through your mouth and then travel through the esophagus to reach the stomach, where digestion begins. The esophagus connects your mouth and stomach. At its end, there is the LES (lower esophageal sphincter). LES is a macular valve that opens to pass the food into the stomach and then closes to keep it down. The stomach secretes a strong acid (HCL) to digest the swollen food. This acid doesn’t injure the stomach wall because it has a protective mucous layer. Unlike the stomach, the esophagus can’t tolerate this acid as it lacks protection against it. Thus, this acid is harmful to the esophagus.
The LES can’t close properly in heartburn, and the stomach contents (including the acid) leak towards the esophagus (acid reflux).
Heartburn is usually occasional and easy to manage with over-the-counter medications and lifestyle modifications. But, prolonged or frequent heartburn may indicate a severe disease, such as GERD (gastroesophageal reflux disease) and hiatal hernia. This burning sensation usually worsens after eating and at night. It may awaken you from sleep. Also, prolonged and ignored heartburn may cause serious complications, including esophageal strictures and cancer.
There is no clear cause for heartburn, but some conditions may raise its risk, such as pregnancy, obesity, smoking, and taking some medications. Also, some foods may trigger or worsen heartburn, like fatty, fried, and spicy foods.
Diagnosing heartburn is easy to establish by history and examination. But, if your doctor suspects any underlying diseases or complications, he will order some investigations to look for them.
Managing heartburn usually doesn’t require more than OTC medications and lifestyle modifications. Lifestyle modifications in heartburn include diet modifications to eliminate the triggering foods and eating the helpful ones.
What is the role of diet in heartburn?
Your diet may put you at a high risk of heartburn and may help you alleviate its burning sensation. Modifying your diet helps with the occasional heartburn and represents a vital component of managing GERD. It isn’t only about what you eat but also how much and when you eat.
Now, let’s discuss which diet habits you should modify, which foods trigger and worsen heartburn, and which foods help.
Heartburn and your diet habits
● How much are you eat?
Before thinking about specific foods to eat or avoid, think about the amount of each meal. In eating, you should be aware that bigger isn’t better. Regardless of what you eat and how much you like this food, a filled stomach raises the risk of heartburn. Eat small frequent meals.
● How do you eat?
Slow down; don’t shovel the food. Don’t grab, gulp, and go because you can’t digest well in this way, and heartburn occurs more frequently. Take your time; eat slowly, and digest well.
Chew gum after eating because it keeps your mouth secreting saliva. Saliva is an alkaline fluid that neutralizes any refluxed acid. It also stimulates your gut to move the digested food faster towards the small intestine. You don’t give the heartburn a chance to set in.
● When do you eat?
Avoid lying down and going to sleep immediately after eating. It is an unhealthy habit that makes heartburn more likely to happen. Make at least 3 hours between your dinner and bedtime to allow your digestive system to digest what you ate.
Which foods worsen heartburn (foods to avoid with heartburn)?
1. Spicy foods
Spicy foods cause heartburn and worsen its symptoms. Many spicy foods, like chili peppers, contain capsaicin. Capsaicin delays gastric emptying and slows down digestion, which promotes acid reflux. Also, these foods may irritate the already irritated esophagus and worsen heartburn.
Also, spicy foods usually contain high fats that trigger heartburn. If you notice that spicy foods cause or worsen your heartburn, avoid them in your diet.
2. Fatty and fried foods
You may like these foods as they seem delicious, but you shouldn’t ignore their harm. These foods raise the risk of heartburn and worsen it. High-fat foods stay longer in your stomach, which stimulates more acid secretion. They also cause LES relaxation, which increases gastric acid leakage into the esophagus. Also, a high intake of these foods raises the risk of overweight and obesity, which are significant risk factors for heartburn.
Examples of these foods include:
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- French fries
- Onion rings
- Full-fat dietary products, like whole milk and regular cheese
- Fried foods, pizza, and sausage
- Desserts and snacks, like potato chips
- Oily foods
Besides heartburn, these foods also raise the risk of atherosclerosis and heart diseases.
Avoid these foods or take them sparingly. Also, instead of frying your favorite foods, you can grill, roast, or broil them. Remove the fat of meat and poultry and the skin of the chicken. Tips like these can lower the risk and improve heartburn.
3. Acidic foods and drinks
These foods, like orange, lemon, grapefruit, tomato, and tomato sauce, are highly acidic. They are healthy foods and contain vitamins, but their acidic nature makes them risky for heartburn. They can trigger heartburn, especially when you eat them on an empty stomach or when you eat them alone. They relax the LES and worsen the burning sensation.
In heartburn, your stomach already secretes too much acid; don’t make the condition worse by eating acidic foods. Limit their intake, or try offsetting them with alkaline (or less acidic) foods, such as low-fat yogurt. Replace the tomato-based sauce with olive oil or pesto sauce, or add some baking soda to it to lower some of its acidity.
4. Chocolate
It’s a common trigger for heartburn that many people like. It triggers heartburn in three ways; it’s rich in fat, caffeine, and cocoa. All of its components relax the LES and cause acid reflux. Chocolate also stimulates the intestine to secrete serotonin, which relaxes the LES.
If you find that chocolate triggers or worsens your heartburn, try avoiding it in your diet. You can also try dark chocolate rather than milk chocolate because it contains less fat and is less risky for heartburn.
5. Carbonated beverages and soda
These drinks create bubbles, like air pockets, which expand your stomach and cause pain and pressure against the LES, relaxing it. They also consist of sugar that ferments in the stomach, producing more gases. They also increase stomach acidity. These factors make these drinks risky for heartburn, especially nocturnal heartburn.
Limit your intake of these drinks or avoid them. You can also try decaf ice tea and dilutable drinks.
6. Peppermint
Mint and mint-flavored products are known for their soothing effect on the irritable bowel. But, they also relax the LES, which promotes acid reflux and triggers heartburn.
Follow if you get heartburn after consuming these products to eliminate them from your diet. You can soothe your bowel with other agents, like chamomile tea.
7. Coffee and caffeinated beverages
These interfere with the LES function and impair its contraction. It also worsens the condition by increasing gastric acid secretion.
Try decaffeinated drinks or dark coffee (it has less caffeine).
8. Alcohol
Alcohol causes and worsens heartburn. It relaxes the LES, irritates the esophagus by itself, and increases gastric acid secretion. All are bad news. Some people tolerate moderate intake, while others have heartburn after one drink. Know your limits and drink accordingly.
White wine is more acidic than red and riskier for heartburn. Beer is carbonated and has acidic nature, and both are bad, but it contains lower alcohol than other beverages. Darker drinks, such as whisky, are more irritative for the stomach and esophagus.
Besides heartburn, alcohol is a risk factor for liver and heart diseases.
- Food isn’t only a risk factor for heartburn. As there are foods to avoid, there are foods to eat. We have foods that help with acid reflux and prevent it.
Which foods can fight heartburn (Foods to eat)?
1. Whole grains
Whole grains help in fighting heartburn. They make you feel full, which makes you less likely to overeat. Whole grains are also high in fibers. This fiber content helps by absorbing the stomach acid, which improves heartburn.
Besides that, whole grains are a rich source of vital nutrients, such as vitamin B, folic acid, iron, selenium, magnesium, and potassium. They are like oatmeal, brown rice, quinoa, popcorn, and whole-grain bread. Keep adequate fluid in your diet to get a more beneficial effect from fibers.
2. Non-citrus fruits and vegetables
Except for citrus fruits (acidic), other fruits and vegetables have a beneficial role in heartburn. They contain low fat and sugar and provide high fibers and other nutrients. For example, we have bananas and melons.
Bananas are an alkaline food that neutralizes stomach acid, relieving heartburn. It also contains a soluble fiber (pectin) that keeps food flowing through the digestive tract (no reflux).
Melons, such as watermelon and cantaloupe, are also alkaline and watery. Watery foods also help by diluting the stomach acid, which improves heartburn. Other helpful fruits and vegetables are broccoli, carrots, beets, green beans, and sweet potatoes.
3. Ginger
It is an excellent digestive aid. Having a cup or two per day helps your digestive system in two ways. It has medicinal and anti-inflammatory features, which alleviates the irritative effect of gastric acid on the esophagus and soothes the stomach.
It’s also an alkaline drink, which neutralizes stomach acid. Both features make it helpful for heartburn and various digestive problems. You can add it to smoothies, stir fry, soups, and tea.
4. Milk and yogurt
Milk and yogurt coat the esophagus, forming a temporary buffer that soothes the esophageal irritation. They are also rich in protein and probiotics (healthy bacteria for your gut).
You can add yogurt to baked goods and fresh fruit. We talk about the skim and low-fat varieties, not the whole milk. Whole milk is rich in fat; thus, it’s risky for heartburn.
5. Lean protein
Lean protein sources include chicken, egg white (not egg yolk), and seafood. T
hey are low in fat, so they are a good substitute for sources rich in fat. It’s better to eat them baked, grilled, or boiled.
6. Legumes
Legumes are vegetables, like beans, peas, and lentils.
They are low in fat and cholesterol and rich in healthy fats and fibers. Also, they provide various nutrients, such as iron, potassium, magnesium, and folic acid. They are a healthy alternative protein source instead of meat (rich in fat and cholesterol).
7. Nuts and seeds
They supply your diet with healthy fats, fibers, and nutrients. These components make them a beneficial choice for heartburn.
Examples include peanuts, almonds, flaxseeds, pomegranate, and chia.
8. Healthy fats
Fat is essential for your body (especially the heart and brain), but it can trigger acid reflux and worsen heartburn. We have two forms of fat: healthy and unhealthy fats. Healthy fats help with heartburn. In addition, they also boost your heart health by reducing the bad cholesterol in your body.
You can find healthy fats in soy products, olive oil, avocado, and walnuts.
Outlook
Heartburn is a common problem that you, I, and millions face frequently. It is usually transient, and you can control it by OTC medications and modifying your lifestyle. Sometimes, it may be due to an underlying disease that requires seeing your doctor and following his instructions.
Whether it is transient or due to disease, you can promote managing your condition by modifying your diet to be healthier. As your diet can be against you, it can fight with you against heartburn. Pay attention to what you eat, and notice what triggers and worsens heartburn. You may not be able to eliminate some foods from your diet completely. Moderation gives you satisfactory results. Don’t forget that the story isn’t only about what you eat. Modifying your diet habits is also vital for your management plan.
Live healthily, and don’t allow acid reflux to impact your life quality.