Causes of Heartburn
and Acid Reflux

Even without knowing the causes of heartburn you know why the name is appropriate.

It feels as though a fire is raging in your chest. The pain can be so intense, in fact, that some people rush to the emergency room in fear they're having a heart attack.

But contrary to its name and its sensation, heartburn has nothing to do with the heart.

It's a burning sensation and pain in the stomach and/or chest, behind the breastbone and is related to indigestion.

In fact, people use different names to describe the same digestive discomfort, but whatever we call it, we're probably trying o describe the uncomfortable results of a meal that disagreed with us.

Discomfort may be mild and infrequent, intermittent, or intense and constant.

Apart from the burning pain in the chest, other symptoms of heartburn may be:

  • abdominal pain
  • bloating, gas
  • excessive salivation
  • belching
  • regurgitation
  • nausea
  • shortness of breath
  • acid or sour taste in the mouth
  • hoarseness of the voice

In industrialized countries heartburn and indigestion are quite common. In fact, approximately 60 millions of Americans suffer from these conditions.

Some Common Causes of Heartburn

a weakened LES allows stomach juices back up again

Heartburn occurs when hydrochloric acid (HCl), which is produced by the stomach to digest food, heads in the wrong direction and backs up into the oesophagus, the tube that connects the mouth with the stomach, causing sensitive tissues to become irritated.

Normally, a tight little muscle at the base of the oesophagus, called the lower esophageal sphincter (LES), prevents juices from escaping, by pinching itself shut once food has entered the stomach.

But, like an old rubber band, this muscular ring can become weakened and stretched so it no longer snaps tightly shut. Or it may relax and spring open at the wrong time.

In either case, acid-laden digestive juices and partially digested food spill past it and back into the oesophagus, causing the "burning" sensation that is heartburn or acid reflux along with a bitter acid taste in the mouth.

The tender lining of the oesophagus, unlike that of the stomach, was not made to endure contact with such caustic substances and thus reacts with irritation and pain.

This is also called gastroesophageal reflux, and conditions that affect the oesophagus and cause a reflux of stomach acids into the oesophagus are now referred as gastroesophageal reflux diseases (GERD) rather than dyspepsia, chronic heartburn or acid indigestion.

GERD can scar the oesophagus and if stomach acids make their way into the lungs, it can cause asthma-like symptoms.

GERD can also lead to a condition called Barrett's oesophagus, which is characterised by changes in the cells lining the oesophagus that results in scarring, constriction of the oesophagus and swallowing disorders. Although Barrett's doesn't cause cancer, it often precedes it.

Other Causes of Heartburn

  • People with hiatal hernia often experience heartburn.
  • Heartburn is common among pregnant women whose organs are squashed in a most peculiar way.
  • Other factors that can increase intra-abdominal pressure include obesity and overeating.

If you're not sure which foods affect you, you might want to try an Elimination Diet to find out.

  • It can also be triggered by excessive consumption of spicy foods, fatty or fried foods, alcohol, coffee, citrus fruits, carbonated drinks, chocolate or tomato-based foods. These foods decrease the tone of the oesophagel sphincter, but each individual can react to different triggers.
  • Other possible causes of heartburn are ulcers, gallbladder problems, stress, allergies and enzyme deficiencies.
  • Some drugs can be among the causes of heartburn, including birth control pills, diazepam, nicotine, nitroglycerine, progesterone, provera, and theophylline.
  • Some triggers include wearing tight-fitting clothes, lying down, bending over and eating large meals.
  • The tendency to reflux is exacerbated if the stomach is overfull, if acids are produced in excess or at the wrong time, or when there is increased pressure in or on the stomach.
  • Eating a large meal late at night or lying down to soon after eating can also result in a sore gullet and, in some cases, a sore throat.


  • You need to use antacid medicines every day or after every meal.
  • You regurgitate acid every day or every night.
  • Pain wakes you during the night.
  • You have any kind of pain brought on by physical activity.
  • You have unexplained shortness of breath, dizziness or nausea.
  • The pain radiates from your chest into your neck and arms - or from the centre to the lower right side of your abdomen.
  • There is loss of appetite or difficulty swallowing.
  • There is any sudden or unexpected weight loss.
  • You notice red blood or anything that resembles coffee grounds in your stools.
  • Any of your symptoms are unrelenting and recurring.

Does What You Eat Affect Heartburn?

Unquestionably, what you eat is a prime - and perhaps THE prime - factor in whether heartburn strikes, how severe it is and whether it worsens through the years.

According to Donald Castell, M.D., professor of medicine at the University of Pennsylvania School of Medicine, although some people may be born anatomically more vulnerable to heartburn, most often the predisposing culprit is your dietary pattern. He blames diet greatly for both bringing on and aggravating heartburn.

A tiny amount of reflux may causes no problem because the area just above the sphincter contains glands that will secrete enough alkaline juices to neutralize the acid.

It's comforting to know that the oesophagus has an amazing ability to self-repair. But repeated attacks or larger quantities of acid will causes pain and burning and, eventually, erosion of the unprotected lining of the gullet.

Much more is said about digestion in Indigestion Causes and Symptoms, where I discuss the role of digestive enzymes and stomach acid.

And the article Natural Remedies for Heartburn vs. Antacids discusses in detail how digestion works and how antacid medications deal with the symptoms.

So it's essential that you find out how changing your diet can deal with the causes of heartburn and get to the root of the problem by reading the following articles:

Foods That Cause Heartburn

Heartburn Remedies and Indigestion Relief

Good Foods for Heartburn

Heartburn During Pregnancy - Healing Foods to Relieve Heartburn


Return to Foods' Healing Power Homepage from Causes of Heartburn

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Articles in This Series:

Causes of Heartburn and Acid Reflux

Indigestion Causes and Symptoms

Natural Remedies for Heartburn

Heartburn Remedies and Indigestion Relief

Foods That Cause Heartburn

Good Foods for Heartburn

Heartburn During Pregnancy - Healing Foods to Relieve Heartburn

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