Heartburn and The Diet Dilemma
You wake at night with an unmistakable burning sensation. Another painful bout of heartburn. For most, heartburn or acid reflux is just an inconvenience. For others, especially those who experience heartburn more than once a week, it can have a major impact on their lives. Diet is one thing that comes under increased scrutiny. People find they can’t eat certain things or at certain times, a daily drama no one wants. To understand what can help, let’s look at what could be causing the problem to begin with.
What causes heartburn?
At the bottom of the esophagus is small sphincter muscle responsible for keeping your stomach acid where its meant to be, in your stomach. However, for many heartburn sufferers this muscle doesn’t work as well as it should, resulting in stomach acid making its way up into the esophagus and burning sensitive tissue i.e. heartburn. While there are multiple reasons this can happen including stress, anxiety, smoking or even pregnancy, the most common cause is diet. Surely then it’s just a case of avoiding fatty or spicy foods, right? Research suggests it’s more complicated than that.
Why food causes heartburn
What foods we eat and how much can not only alter the amount of stomach acid being produced but the physical shape of the stomach. Eat too much in one sitting and you can stretch the stomach, ultimately putting pressure on that sphincter muscle. Eat high fat foods and your stomach has to work harder to digest it, the result being more stomach acid can splash back into the esophagus. The tricky part is understanding exactly what foods give you the most trouble and how much or little you can consume before they become a problem. Also keep in mind different foods affect different people in different ways.
Citrus Juices
Drinking high citric acid-based juices like orange, grapefruit, tomato juice and even some soft drinks like lemonade is often linked to triggering heartburn. In a 1995 study of people that suffer from heartburn, 34% of participants experienced heartburn when consuming grapefruit juice and 32% from orange juice1. Keep this in mind the next time you reach for the OJ and not the H20.
Chocolate
Unfortunately for chocoholics, chocolate is often linked with heartburn symptoms. Studies show that chocolate can relax the sphincter muscle which allows acid to escape the stomach into the esophagus2. Additionally, cocoa, a primary ingredient in chocolate, contains the feel-good hormone serotonin which has also been linked to relaxation of the sphincter muscle3.
High Fat Foods
We’re not just talking the obvious high-fat offenders of greasy fried foods but also nutritious high-fat options like nuts, avocados and cheese. High-fat foods cause our bodies to release a specific hormone which aids digestion. Unfortunately, this hormone also relaxes (you guessed it) the sphincter muscle4. Additionally, large, high fat meals will sit in the stomach longer5 which can result in a bout of heartburn as more stomach acid is produced.
Spicy Foods (or not?)
Many believe spicy food causes their heartburn and they might be right. Spicy food usually contains chilli pepper and within that is a chemical known as capsaicin. Capsaicin increases gastric motility and emptying i.e. it makes you want to go to the toilet. So if you get heartburn from an Indian curry it could be the way chilli peppers react to you but just keep in mind it’s equally likely the result of fat and salt which often accompanies spicy foods.
Alcohol
Ok, so there’s no hard and fast rule with alcohol simply because it’s not fully known if it actually causes heartburn or just exacerbates the problem. Evidence is leaning towards alcohol causing heartburn, primarily due to studies showing a relationship between alcohol and more severe form of heartburn knows as GERD6. And, some types of alcohol such as beer and wine have been linked to higher production of stomach acid7. It doesn’t take a rocket scientist to figure out what that can mean if all that acid reaches the esophagus.
What can help?
If you’re experiencing heartburn more than once a week you may be suffering from GORD/GERD, so there's undoubtedly a lot of dietary considerations you weigh up each day. It may get to a point you deliberately avoid certain foods altogether, forgoing one of life’s most basic pleasures. It doesn’t have to be this way. Your pharmacist can advise on treatment options and may even recommend Losec®. Unlike antacids which only temporarily neutralise stomach acid, Losec® reduces the amount of acid your stomach produces. As a result, Losec® can help relieve heartburn for up to 3 months at a time8,9. Just remember that Losec® is not a get out of jail card for you to eat copious amounts of whatever you want. It’s a treatment for heartburn first and foremost and any positive affects it can provide day to day should be the result of you eating a balanced, responsible diet at the same time.
For more on Losec® and where to buy it, CLICK HERE
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1. M Feldman, Relationships between the acidity and osmolality of popular beverages and reported postprandial heartburn, https://pubmed.ncbi.nlm.nih.gov/7806034/, Accessed 6 September 2021.
2. Lewis e. Wright et al, The adverse effect of chocolate on lower esophageal sphincter pressure, The American Journal of Digestive Diseases, https://link.springer.com/article/10.1007%2FBF01070826, Accessed 6 September 2021.
3. Study Offers Hope For Chocolate-Loving Reflux Disease Sufferers. ScienceDaily, 23 May 2001. www.sciencedaily.com/releases/2001/05/010523072217.htm. Accessed 20 October, 20121.
4. M Ledeboer et al, Effect of cholecystokinin on lower oesophageal sphincter pressure and transient lower oesophageal sphincter relaxations in humans, https://gut.bmj.com/content/36/1/39, Accessed 6 September, 2021.
5. K Iwakiri et al, Relationship between postprandial esophageal acid exposure and meal volume and fat content, https://pubmed.ncbi.nlm.nih.gov/8625764/, Accessed 6 September, 2021.
6. Jiaqi Pan et al. Alcohol Consumption and the Risk of Gastroesophageal Reflux Disease: A Systematic Review and Meta-analysis, https://pubmed.ncbi.nlm.nih.gov/30184159/, Accessed 6 September, 2021.
7. S Chari et al. Alcohol and gastric acid secretion in humans, https://pubmed.ncbi.nlm.nih.gov/8314520/, Accessed 6 September 2021.
8. When taken daily for 2 weeks.
9. Fendrick et al. (2004) Self-Selection and Use Patterns of Over-the-Counter Omeprazole for Frequent Heartburn. Clinical Gastroenterology and Hepatology 2:17-21.
Losec and MUPS are registered trade marks of the AstraZeneca group of companies. Losec is a Pharmacy Only Medicine. Each Losec tablet contains 10mg omeprazole and each Losec Extra tablet contains 20mg omeprazole. For the short-term relief of reflux-like symptoms. Losec: Take 2 tablets once daily and reduce to one tablet daily when symptoms improve. Losec Extra: Take 1 tablet daily. Not to be used if under 18 years old, in presence of alarm symptoms or if pregnant. Please refer to the label or Consumer Medicine Information for further information. Always read the label and follow the instructions. If symptoms persist, see your healthcare professional. Bayer New Zealand Limited, Auckland.
