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What Increases the Risk of Having Heartburn?


Updated May 22, 2009

Question: What Increases the Risk of Having Heartburn?
Answer: There are factors that can increase your chances of experiencing heartburn. Some of these factors for heartburn may be beyond your control, such as another medical condition or pregnancy. Other factors, such as certain lifestyle habits, can be modified to help reduce the occurrence of heartburn symptoms.

What increases your risk of suffering from heartburn?

Being overweight (obesity)
Excess body fat pushes on the stomach, increasing gastric pressure. Obese people tend to have decreased lower esophageal sphincter (LES) pressure and impaired gastric emptying. Each of these can contribute to an increase in heartburn occurrence.

Being pregnant
You may experience heartburn during pregnancy because of increased levels of hormones in your body that soften the ligaments that normally keep the LES tightly closed. If the LES relaxes at the wrong time, stomach contents can reflux back up into your esophagus and throat. Also, as the baby grows, pressure is put on your stomach. This, in turn, can force stomach contents through the LES and into your esophagus.

Smoking stimulates the production of stomach acid. It can also weaken and relax the LES. Smoking has also been shown to slow the production of saliva. Saliva is one of your body's defenses against damage to the esophagus, because it contains chemicals that help to neutralize acid. Research shows that the saliva of smokers contains smaller amounts of bicarbonates, thus reducing the ability of the saliva to neutralize the acid. Saliva also bathes the esophagus and lessens the effects of acid that has refluxed up from the stomach, and helps wash the acid down to the stomach.

Drinking alcohol
Alcohol increases the production of stomach acid, and relaxes the LES. Alcohol also makes the esophagus more sensitive to stomach acid.

Eating certain foods
Some foods can increase the odds of having heartburn. These problem foods include:
  • Fatty foods
  • Citrus fruits (such as oranges)
  • Tomatoes and tomato-based products (such as tomato sauce, tomato paste, many spaghetti sauces)
  • Coffee
  • Alcoholic beverages
  • Citrus fruit drinks (such as orange and grapefruit)
  • Chocolate
  • Peppermint
  • Pepper
Having a hiatal hernia
A hiatal hernia can weaken the LES and cause reflux. It can also result in the retention of acid and other stomach contents above the opening in the diaphragm, where the esophagus connects with the stomach (hiatus), and can result in this being easily refluxed into the esophagus.

Having gastroparesis
Gastroparesis, also called delayed gastric emptying, is a disorder in which the stomach takes too long to empty its contents. It often occurs in people with type I diabetes.

Sources: "Heartburn and GERD FAQ." American College of Gastroenterology. 19 May 2009

"Heartburn, Gastroesophageal Reflux (GER), and Gastroesophageal Reflux Disease (GERD)." NIH Publication No. 07–0882 May 2007. National Digestive Diseases Information Clearinghouse (NDDIC). 19 May 2009

Howard Hampel, MD, PhD; Neena S. Abraham, MD, MSc(Epi); and Hashem B. El-Serag, MD, MPH, "Obesity and the Risk for Gastroesophageal Reflux Disease and Its Complications." 2 August 2005 | Volume 143 Issue 3 | Pages 199-211. Annals of Internal Medicine - The American College of Physicians. 19 May 2009.

Oliveria SA, Christos PJ, Talley NJ, Dannenberg AJ, "Heartburn risk factors, knowledge, and prevention strategies: a population-based survey of individuals with heartburn" 1999 Jul 26;159(14):1592-8. National Center for Biotechnology Information - U.S. National Library of Medicine. 19 May 2009.

"Is it just a little HEARTBURN or something more serious?." American College of Gastroenterology. 19 May 2009

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