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Risk Factors for Heartburn

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Updated June 28, 2007

A risk factor is something that increases your chances of getting a disease or condition. The same is true with heartburn. Some of the risk factors for heartburn may be beyond our control, such as another medical condition. 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)
While researchers are still studying exactly how obesity increases the risk of heartburn, they do state that it is biologically possible. Excess body fat pushes on the stomach, increasing gastric pressure. Also noted in obese patients are decreased lower esophageal sphincter (LES) pressure and impaired gastric emptying. Each of these can contribute to an increase in heartburn occurrence.

Being pregnant
You can experience heartburn duing pregnancy because of increased levels of hormones in your body while pregnant can soften the ligaments that normally keep the lower esophageal sphincter (LES) tightly closed. If the LES relaxes at inappropriate times, food and stomach acids can reflux back up into your esophagus and throat. Also more pressure is put on your stomach as your body changes and your baby grows. This, in turn, can force stomach contents through the LES and into your esophagus.

Smoking
Smoking stimulates the production of stomach acid. It can also weaken and relax the lower esophageal sphincter (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. Saliva even has acid-neutralizing chemicals called bicarbonates. 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. Alcohol can lead to the development of peptic ulcers and interfere with the healing of ulcers already present.

Eating certain foods
Some foods can increase the odds of having heartburn. These include:

  • Fried foods
  • 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 a peptic ulcer
A peptic ulcer is a sore or lesion that forms in the lining of the stomach or duodenum. These ulcers can cause a gnawing or burning pain in the abdomen between the breastbone and navel. There can also be acid reflux, the sensation of acid backing up into the throat.

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 or type II diabetes. Gastroparesis happens when nerves to the stomach are damaged or stop working. The vagus nerve controls the movement of food through the digestive tract. If the vagus nerve is damaged, the muscles of the stomach and intestines do not work normally, and the movement of food is slowed or stopped. This delayed stomach emptying can increase gastric pressure, which can lead to heartburn.

Sources:

"Heartburn, Gastroesophageal Reflux (GER), and Gastroesophageal Reflux Disease (GERD)." NIH Publication No. 07–0882 May 2007. National Digestive Diseases Information Clearinghouse - National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health. 26 Jun 2007.

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. 26 Jun 2007.

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. 26 Jun 2007.

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