How to Prevent Heartburn

Occasional heartburn is very common, but for some people, it is more frequent and can interfere with their daily life. The good news is that there are simple lifestyle tips that can help prevent episodes of heartburn. These include how and what you eat and drink, sleeping habits, and even how you dress.

Many prevention tips discuss the lower esophageal sphincter (LES). The LES is the valve at the junction between esophagus and stomach. If the LES isn't working properly or relaxes inappropriately, stomach contents can reflux back up into the esophagus. The stomach acid and food can irritate the esophagus, causing heartburn.

You should see your doctor for an evaluation if you have heartburn more than twice a week and it isn't relieved with over-the-counter remedies. If you are diagnosed with gastroesophageal reflux disease (GERD), these heartburn prevention tips are ones that are likely to be included in your treatment plan.

Smoking

Smoking leads to more heartburn in several ways:

  • Smoking reduces saliva production. Saliva is naturally alkaline, so it can help neutralize stomach acid.
  • Smoking can weaken and relax the LES.
  • Smokers are prone to coughing, which increases abdominal pressure and can lead to heartburn.

Exposure to secondhand smoke is also linked to heartburn, so you should avoid places where people smoke.

Diet

Alcohol Consumption

Alcoholic beverages, including beer, wine, and distilled spirits, can trigger heartburn. Alcohol increases the amount of acid the stomach produces and relaxes the LES. For some people, an occasional alcoholic drink doesn't cause reflux. For others, even a small drink will result in heartburn. The following tips can reduce the risk:

  • Dilute alcoholic beverages with water or club soda.
  • Drink moderate amounts of alcoholic beverages. The suggested amounts are one to two mixed drinks, 12 to 16 ounces of wine, or two to three beers.
  • When having wine, drink white wine instead of red.
  • Choose non-alcoholic beer or wine.
  • Keep track of which alcoholic drinks aggravate your heartburn, and avoid them as much as possible.

Dietary Patterns

A full stomach can put extra pressure on the LES. You may try eating six smaller meals each day instead of three larger ones. Or you can try having your larger meal earlier in the day and have a light meal for supper. Avoid late-night snacking.

Don't lie down for two to three hours after a meal. It's even best to sit upright rather than slouching. The LES tends to relax when you lie down, and a full stomach can cause stomach contents to press harder against the LES. Also, your digestive system slows down when you sleep. The food in your stomach stays there longer at the same time you are in a prime position for the food to be refluxed.

Drink plenty of water, which helps with digestion. However, drinking too much water at one time increases the volume of stomach contents and can worsen heartburn symptoms. It is better to drink smaller amounts throughout the day rather than large amounts less often. Another trick is to drink a glass of lukewarm water or herbal tea after a meal to dilute and flush out stomach acid.

Chewing gum after a meal can also help prevent heartburn. It stimulates saliva, which acts to buffer stomach acid, and the saliva bathes the throat to protect it.

Avoiding Food Triggers

Certain foods can trigger heartburn symptoms in many people, and it's best for people with chronic heartburn to limit or completely avoid these foods and beverages. Though everyone is different, here is a list of the most problematic foods for people with heartburn.

  • Deep-fried foods are one of the major triggers of heartburn and acid reflux. French fries, fried chicken, blooming onions, and other oil-drenched foods are hard to digest and can increase your chances of having a heartburn episode.
  • Fatty foods slow digestion. The longer you have food lingering in your stomach, the more likely you will feel heartburn. Steer clear of highly fatty foods and meals like cheesy casseroles, pizza, and desserts. Marbled cuts of meat, the skin of poultry, and creamy sauces could also pose a problem for heartburn.
  • Acidic foods like citrus fruits can stimulate acid production and increase heartburn. Avoid oranges, grapefruit, lemons, and their juices.
  • Tomatoes and tomato products (tomato sauce, tomato paste, tomato juice) can stimulate the stomach to produce more acid. Foods that combine several heartburn offenders, such as pizza (tomato sauce and fatty cheese) or lasagna (tomato sauce, cheese, and meat) can be particularly problematic for people prone to heartburn.
  • Coffee has two strikes against it when it comes to heartburn. Caffeine can stimulate acid, plus coffee is an acidic beverage. You may find you can tolerate decaf, but you may have to cut out coffee altogether to see if that helps reduce heartburn episodes.
  • Chocolate can prevent the LES from fully closing, which then causes stomach acid to creep up into the esophagus, causing the fiery pain of heartburn.
  • Peppermint relaxes the LES. While peppermint tea might seem like a soothing remedy for heartburn, it can make it worse.
  • Spicy foods are another trigger for heartburn, as they can irritate the esophagus. Get to know your spice threshold.

Foods That Are Safer

When eating out or cooking at home, consider having these foods that are less likely to trigger heartburn:

  • White meat
  • Lean cuts of meat
  • Sandwiches with turkey, chicken, or roast beef on whole grain bread
  • Grilled foods
  • Broth-based soups
  • Steamed vegetables
  • Baked potatoes topped with low-fat salad dressing
  • Low-fat or no-fat salad dressings
  • Lighter desserts, such as angel food cake

Weight Management

Whether due to belly fat or being pregnant, excess weight on the abdomen increases abdominal pressure, which can push stomach contents up into the esophagus. The good news is that for many people, as little as a 10 percent decrease in weight will improve their heartburn symptoms. If you are battling your weight, your heartburn may be a warning sign of other dangers that may occur. Not only is reflux increased by obesity, but so is the risk of Barrett's esophagus and esophageal cancer. Since eating smaller meals seems to help with heartburn, reducing your portion size can have a double benefit if you want to lose weight.

Clothing

Don't wear belts, slenderizing undergarments, or clothes that are tight-fitting around the waist. These items can squeeze the stomach, force food up against the LES, and cause reflux and heartburn.

Medications

A wide variety of medications can worsen heartburn symptoms. Talk to your doctor about any prescriptions, over-the-counter products, and supplements you are taking. Your doctor may be able to change the schedule of your medications to help reduce the effects. Also, if you take a medication to prevent heartburn there may be a better time to take it if you have nighttime heartburn.

During Exercise

Exercise and other vigorous activities like shoveling snow or hard manual labor can cause the contents of the stomach to move around and lead to heartburn. Before calling it quits on your exercise program, or shirking tougher tasks, use these tips:

  • Wait at least an hour after eating before you begin to exercise or exert yourself.
  • Avoid the food and drink triggers of heartburn before exercise.
  • Take an over-the-counter antacid before exercising. It may be best to use an antacid that also contains an acid reducer, such as an H2 blocker or proton pump inhibitor.
  • Choose your exercise wisely. Higher impact activities, such as running or jogging, can increase your chances of getting heartburn compared to lower impact activities, such as walking, biking, or swimming.

You don't want to ditch exercising completely since exercise can also help improve your GERD symptoms.

Stress

More than half of people who have frequent heartburn say a hectic lifestyle and work-related stress increases their heartburn. While stress hasn't been linked directly to heartburn, it is known that it can lead to behaviors that can trigger heartburn. During stressful times, routines are disrupted and people may not follow their normal routines in regards to meals, exercise, and medication. It is important to find ways to alleviate the stress, and thus make stress-related heartburn less likely.

  • Regular exercise not only helps to lower stress and increase your natural "feel-good" chemicals, known as endorphins but also helps with digestion.
  • Get seven to eight hours of sleep per night. Sleep-deprived people have higher stress levels.
  • Eat balanced meals. By consuming plenty of fresh fruits, vegetables, and fresh fish, you'll provide your brain and body with the necessary nutrients to help you perform under pressure. It is also important to avoid the foods that are your heartburn triggers.
  • Limit your consumption of alcohol, caffeine, and tobacco. These substances cause the stress response to become heightened and are also heartburn triggers.
  • Relax with a quick "mental break." Envision a favorite place in your mind; anyplace that makes you relax just thinking about it.

Symptom Record

Record what triggered your acid reflux episodes, the severity of each episode, how your body reacts, and what gives you relief. The next step is to take this information to your doctor so the both of you can determine what lifestyle changes you will need to make and what treatments will give you maximum relief.

Nighttime Heartburn

Nighttime heartburn is a common problem, including during pregnancy. In addition to not eating within two to three hours of bedtime, follow these tips.

  • Sleep with your head and shoulders elevated. Raise the head of the bed 6 to 8 inches using blocks of wood or risers. You could also use a foam wedge or a sleeping wedge pillow. You shouldn't simply use extra pillows as you can create a bend at your waist rather than a slope and increase the pressure on the stomach.
  • Sleep on your left side. This position aids digestion and helps with the removal of stomach acid.
  • Make sure your bed clothes are loose-fitting.
  • Take an antacid when heartburn hits. Antacids will work very quickly on heartburn you may be experiencing before you go to bed. If you are taking an antacid more than once or twice a week, you should see your doctor about another treatment plan.

How Your Doctor Can Help

If your heartburn is frequent and it is upsetting your daily life, have it evaluated by your doctor. Chronic heartburn is a symptom of gastroesophageal reflux disease (GERD) and some other digestive disorders. Untreated acid reflux may lead to complications, including esophageal cancer. Your doctor can prescribe a treatment for heartburn or acid reflux.

If you are prescribed medication for heartburn, be sure to take your medication at the same time every day. If you are prone to forgetting, leave yourself a reminder note, or take your medication when you do another daily activity that you don't forget doing, such as brushing your teeth or washing your face.

Sources:

Allampati S, Lopez R, Thota PN, Ray M, Birgisson S, Gabbard SL. Use of a Positional Therapy Device Significantly Improves Nocturnal Gastroesophageal Reflux Symptoms. Diseases of the Esophagus. 2016. doi:10.1111/dote.12495.

Eating, Diet & Nutrition for GER & GERD. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/digestive-diseases/acid-reflux-ger-gerd-adults/eating-diet-nutrition.

Heartburn Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/heartburn/diagnosis-treatment/drc-20373229.

Ness-Jensen E, Hveem K, El-Serag H, Lagergren J. Lifestyle Intervention in Gastroesophageal Reflux Disease. Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association. 2016;14(2):175-182.e3. doi:10.1016/j.cgh.2015.04.176.

Symptoms & Causes of GER & GERD. National Institute of Diabetes Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/digestive-diseases/acid-reflux-ger-gerd-adults/symptoms-causes.