If you are reading this, then at some time in your life, you have had heartburn after a meal. It’s happened to us all! For me, that extra pepper or jalapeno in a plate of fajitas gives me just enough heartburn to make me swear off fajitas for life. Or until the next Friday. But in all seriousness, we know that certain food items can either gives us heartburn or make our pre-existing heartburn worse. Some examples include:
- Alcohol, particularly red wine
- Carbonated beverages
- Citrus fruits and juices
- Tomatoes and tomato-based foods
- Spicy foods
- Foods high in fat content
- Fried foods
Causes of Heartburn
But why do these foods cause heartburn? Some share the same mechanism of action, and others work in completely different ways to reach the same end result: reflux and heartburn (the discomfort from acid contents refluxing from the stomach into the esophagus)
Lower esophageal sphincter relaxation
The lower esophageal sphincter separates the esophagus from the stomach and protects stomach contents from “refluxing” up from the stomach and into the esophagus. When we swallow, the sphincter relaxes, allowing food (or liquids) to pass from the esophagus and into the stomach. And then it re-tightens, protecting the esophagus from stomach contents “refluxing” back up.
Chocolate, peppermint, caffeine and alcohol are all classic examples of foods that will cause the lower esophageal sphincter to relax. What can happen is that you have just finished a dessert of chocolate pie & red wine and the stomach is now producing stomach acid in order to digest your dessert. The chocolate and alcohol can cause the lower esophageal sphincter to relax, and now you have heartburn.
In addition to causing lower esophageal sphincter relaxation, chocolate also contains theobromine, a stimulant that can cause reflux, and the fat content of chocolate can cause reflux.
After these beverages are ingested, the carbonation bubbles expand and when they have expanded, the increased pressure within the stomach causes reflux. Unfortunately, carbonated beverages with caffeine pose a double whammy as the carbonation causes expansion of the stomach and the caffeine leads to relaxation of the lower esophageal sphincter
Fatty foods (including fried foods)
Fatty foods cause reflux and heartburn through a couple of different mechanisms. To start with, fatty foods remain in the stomach longer than low fat foods. Because they are in the stomach longer, your stomach has to produce more stomach acid. Second, fatty foods cause the lower esophageal sphincter to relax.
So now you have a situation where your stomach has produced more stomach acid than normal, and the fat is causing your LES to relax, exposing your esophagus to all of that excess stomach acid. Something similar happens with large meals, regardless of what you have just eaten.
If you have a large meal, then the stomach has to stretch in order to accommodate that meal. When the stomach expands, it stretches the lower esophageal sphincter, changing the shape of the LES and putting you at risk of reflux and heartburn.
Citrus fruits & Tomatoes
Citrus fruits and tomatoes are highly acidic. Your stomach is going to produce stomach acid in order to aid in the process of digestion, regardless of what is eaten, so reflux can worsen when you consume foods that are already high in acidity content, and then your stomach produces more stomach acid in order to digest these foods. The effects of citrus induced reflux are even more noticeable when citrus fruits are consumed on an empty stomach.
Garlic, mint, onion & spices
Although these add a nice flavor to our foods, they can irritate the lining of the stomach, leading to symptoms of indigestion, reflux and heartburn.
Heartburn Remedies and Tips
That’s a pretty long list of items that can trigger reflux and heartburn – what can you do about your reflux?
- Either avoid items that trigger your reflux, use small amounts, or use substitute ingredients (for instance, broths in place of tomato sauce).
- Eating small, frequent meals instead of three traditionally sized meals per day
- Do not lie down for three hours after you eat a meal. It is easier for stomach acid to flow side to side and into your esophagus (if you lie down after a meal) as opposed to flowing up and down if you stay upright after a meal.
- Incorporate more elements of either a Mediterranean diet or a low carbohydrate diet into your meal plans.
- Medications. In addition to prescription medications, there are alternatives including aloe vera, zinc L-carnosine and algae based products that can help reduce the symptoms of acid reflux and heartburn.
- Exercise regularly with the goal of reducing your “central” (think belly) fat and losing weight