Heartburn relief: Simple remedies to put out the fire

Heartburn is a burning feeling in your chest, often behind the breastbone that is a symptom of acid reflux. Despite its name, it originates in the esophagus and not the heart. The esophagus is a tube that connects the throat to the stomach, and when stomach acid backs up and gets past the esophageal valve, we feel it. 

What heartburn feels like

• burning pain in chest
• sour taste in the throat
• sore throat
• wheezing or coughing

The burning feeling may be worse after lying down or bending over. This is also true for indigestion which may be experienced at the same time as heartburn but isn’t always. There are some different symptoms between the two. Indigestion impacts your lower abdomen as opposed to your chest and esophageal areas. A burning feeling in the stomach or bloating as well as excessive gas or belching are often signs of indigestion and not heartburn.

Causes of heartburn

Heartburn is common and can be caused or made worse by lifestyle choices and physical issues, including:

• certain foods and drinks
• being overweight
• overeating
• smoking
• stress and anxiety
• pregnancy
• certain medicines
• a hiatal hernia.

Prevention strategies for heartburn relief

While heartburn triggers vary from person to person, there are foods we can avoid and steps we can take to limit the likelihood of heartburn. If you can’t find the culprit, you may want to record what you’re eating to pinpoint when symptoms flare up.

Foods to avoid

While heartburn triggers vary from person to person, there are several foods and drinks that are known causes of heartburn, including:

• spicy foods: hot chili peppers
• acidic foods: citrus fruits, tomatoes, chocolate
• peppermint
• fatty foods
• acidic drinks, such as caffeine, alcohol, coffee, wine and carbonated beverages. 

Foods that may help with heartburn

An imbalance of beneficial bacteria in your gut can trigger your heartburn symptoms. Some people can improve gut health by adding gut-friendly prebiotics and probiotic food to their diet.

• Lean proteins like chicken, fish and beans can help regulate the production of stomach acid.
• Watery foods like celery, lettuce and watermelon can dilute stomach acid.
• High-fiber foods like oatmeal, brown rice and root vegetables make you feel full, so you don't overeat.
• Alkaline foods like bananas, melons and cauliflower which have a higher pH can help offset strong stomach acid.

Consider probiotics

In addition to focusing on gut-friendly foods, consider adding prebiotics and probiotic food to your diet.

Probiotics aren’t for everyone and aren’t scientifically proven to improve acid reflux. Ask your health care provider before taking probiotics and dietary supplements.  

Don’t smoke

The nicotine from smoking and vaping can irritate your esophagus and may weaken the valve between the esophagus and stomach allowing stomach acid to back up into the esophagus.

Maintain a healthy weight

Excess weight may put too much pressure on your stomach, which in turn allows stomach acid to escape.

Practice portion control

Overeating can increase the pressure in the stomach, leading to increased frequency and or severity of reflux. 

Curb heartburn at night

Some people with heartburn complain about worsened symptoms when they lie down at night. When you’re sitting or standing, gravity helps pull down stomach acid, which doesn’t happen when you’re lying down. Also, this position makes it easier for stomach acid to leak past the esophageal sphincter – the muscle that stops stomach acid. When you’re sleeping, swallowing is also less frequent, so your body doesn’t clear out the acid.

To counter this nighttime discomfort, wait at least three hours after eating before bedtime to give your stomach time to empty itself. You can also try raising the head of your bed, so your chest and head are above your waist. This helps prevent stomach acid from traveling into your esophagus.

Treatments for heartburn

Several treatments can help relieve heartburn, including lifestyle changes, over-the-counter medications and surgery.

Natural remedy: Use baking soda

You may find relief from infrequent heartburn with sodium bicarbonate, otherwise known as baking soda. Simply mix ½ teaspoon with 4 ounces of water to help neutralize the acid. Note this contains sodium and should not be used if you are on a sodium-restricted diet. Check with your doctor if you are taking any prescriptions drugs, are pregnant or have a chronic health condition before using baking soda to relieve heartburn.

Over-the-counter medications

• Calcium-based antacids can relieve infrequent heartburn symptoms.
• H2 blockers (histamine H2-receptor antagonist) and proton-pump inhibitors reduce the amount of acid produced by the stomach. They are stronger and longer acting, giving you longer heartburn relief. 

Over-the-counter heartburn medicine can temporarily decrease the frequency and severity of your acid reflux. Don’t take these drugs indefinitely without asking your doctor. If you have frequent heartburn for more than six weeks, or if these treatments don’t help relieve your heartburn, you should see your primary care provider.

GERD surgery for heartburn

Surgery is a reasonable treatment option for heartburn and regurgitation not responsive to diet, lifestyle and medial management. Our surgery team at Allina Health can discuss GERD surgery for heartburn options with you. 

When to seek care for heartburn

Don’t ignore heartburn. Stomach acid can damage your esophagus and increase your risk of cancer. Sometimes natural remedies and over-the-counter medications are not enough to reduce your symptoms of heartburn, and prescription medications or surgery may be necessary. Your doctor can help determine if your heart burn symptoms are consistent with acid reflux or GERD (gastroesophageal reflux disease).

Consider scheduling an appointment with your primary care provider if you are experiencing any of these concerns:

• Lifestyle changes and medicines are not helping.
• You have heartburn more than twice a week.
• You have other symptoms like food getting stuck in your throat, vomiting or unintentional weight loss.

If you notice more severe symptoms, such as chest pain, dark-colored (coffee grounds) vomit, black stools, persistent vomiting, or feel like you are choking, seek care in the emergency room right away.