How To Prevent Heartburn (Acid Reflux)

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Medically reviewed by Jay N. Yepuri, MD

Heartburn, also known as acid indigestion, is a burning sensation in the chest caused by stomach acid backing up into the esophagus. This occurs when the lower esophageal sphincter (LES) weakens or relaxes. The LES is a muscular ring that normally prevents stomach contents from flowing back up. Gastroesophageal reflux disease (GERD) is a more serious form of heartburn.

Factors like spicy or fatty foods, large meals, obesity, smoking, and certain medications can contribute to LES dysfunction and increase the likelihood of experiencing heartburn.

While heartburn may not be entirely preventable due to physiological factors, effective strategies can reduce its occurrence or delay its development. Understanding these preventive measures can empower you to take proactive steps towards better digestive health and improved quality of life.

Who Is Most at Risk?

Hiatal hernia is one condition that can increase the chances of heartburn. Part of your upper stomach protrudes through your diaphragm into your chest area, and the diaphragmatic hiatus (the opening for the esophagus) becomes enlarged. It allows a portion of your stomach to move up through this opening, disrupting the normal function of the lower esophageal sphincter (LES). Consequently, acid reflux occurs more frequently as the diaphragm no longer supports the LES as effectively.

Several other factors can contribute to an increased risk of experiencing heartburn, such as:

• Consuming spicy, fatty, or acidic foods
• Obesity or excess weight, especially around the abdomen, which puts pressure on the stomach
• Hormonal changes during pregnancy, which relax the LES
• Tobacco use, which weakens the LES
• Older age, due to changes in digestive function and the weakening of the LES over time

Medications

Taking medications for other conditions may increase your risk of heartburn. Medications that may cause heartburn include:

• Beta-blockers or calcium channel blockers for high blood pressure
• Tricyclic antidepressants
• Sedatives for anxiety or sleep conditions
• Anticholinergics (medications that stop involuntary body functions, such as drugs used for sea sickness)
• Bronchodilators for asthma or other lung diseases
• Dopamine-like drugs for Parkinson’s disease (a progressive neurological disorder that affects motor function)
• Progestin for abnormal menstrual bleeding or birth control

Not everyone will experience heartburn from these medications, but they may increase the risk, especially when taken in higher doses or for extended periods.

Genetics

Heartburn, specifically gastroesophageal reflux disease (GERD), has a genetic component to it. Studies on families and twins have shown that genetics contribute significantly, with about 31% of GERD being heritable.

Specific gene variations, such as FOXF1 and MHC, are associated with increased GERD risk, as well as related conditions like Barrett’s esophagus (abnormal esophagus lining) and esophageal adenocarcinoma (cancer). Understanding these genetic factors could lead to new treatments for GERD and its related disorders.

How To Reduce Risk 

Many strategies can help prevent and alleviate heartburn and other GERD symptoms. If you continue to experience discomfort, consult your healthcare provider for further guidance.

Start by avoiding foods and beverages known to trigger reflux, such as:

• Alcohol
• Caffeine
• Carbonated drinks
• Chocolate
• Citrus fruits and juices
• Peppermint and spearmint
• Spicy or fatty foods, as well as full-fat dairy products
• Tomatoes and tomato sauces

Adjust your eating habits with these tips:

• Refrain from bending over or engaging in strenuous activity immediately after meals
• Avoid eating within 3-4 hours of bedtime, as lying down with a full stomach can exacerbate reflux
• Opt for smaller, more frequent meals throughout the day

Lifestyle Habits

Other lifestyle habits and shifts can help reduce the risk of heartburn, including:

• Avoid tight-fitting clothing or belts that put pressure on the stomach and may contribute to reflux
• If overweight, strive to lose excess weight, as obesity can increase stomach pressure and lead to reflux symptoms
• Elevate your head about six inches while sleeping to prevent food from backing up into the esophagus (e.g., by using blocks under the head of your bed or a wedge-shaped pillow)
• Avoid smoking

Complementary Methods

Many studies have connected a relationship between gastrointestinal disorders, such as GERD, and psychological stress. Managing stress through relaxation techniques and seeking support from healthcare providers or counselors may help reduce the effects of stress on digestive health and minimize the risk of heartburn.

Relaxation techniques include:

• Biofeedback (a technique that teaches you how to control some of your body’s functions, such as heart rate)
• Deep breathing
• Meditation
• Yoga
• Tai Chi

Medications

Consider talking to your healthcare provider about over-the-counter (OTC) medications like:

• Antacids, such as Mylanta (aluminum hydroxide/magnesium hydroxide/simethicone) or Tums (calcium carbonate)
• H2 blockers, such as Pepcid AC (famotidine) or Tagamet HB (cimetidine)
• Proton pump inhibitors (PPIs), such as Prilosec OTC (omeprazole), Prevacid 24 HR (lansoprazole), or Nexium 24 HR (esomeprazole)

Surgery and Procedures

A Nissen fundoplication is a surgical procedure used to treat severe GERD or chronic acid reflux. During this procedure, the surgeon wraps the upper part of the stomach (the fundus) around the lower part of the esophagus and sews it in place. This creates a tighter valve mechanism at the lower end of the esophagus (LES). It prevents stomach acid from flowing back into the esophagus.

A Nissen fundoplication may be an option when lifestyle shifts, medications, and other non-surgical treatments fail to adequately control severe GERD symptoms like persistent heartburn, regurgitation, and esophageal damage.

While this surgery can be highly effective for many patients with severe GERD, it’s typically considered after trying and evaluating more conservative treatments.

Discuss With Your Healthcare Provider

Discuss your concerns about developing heartburn with your healthcare provider and ask them which preventative measures you can take. Discuss any major lifestyle or medical changes with them before trying new strategies.

Contact your healthcare provider if you experience frequent, severe, or persistent symptoms of heartburn, such as:

• Bleeding
• Vomiting
• Loss of appetite
• Trouble swallowing
• Unintentional weight loss
• A feeling like food is stuck behind your breastbone
• Getting full very quickly
• Choking or shortness of breath

A Quick Review 

Heartburn, also known as acid indigestion, results from stomach acid flowing back into the esophagus. It’s often due to factors like weakened muscle function in the esophagus or certain lifestyle habits.

While heartburn may not always be preventable, understanding the triggers and adopting preventive measures can significantly reduce its occurrence or delay its onset. Avoiding trigger foods, managing stress, and seeking medical advice when needed are key strategies to alleviate heartburn and improve digestive health.

Talk with your healthcare provider for personalized guidance in addressing frequent, severe, or persistent symptoms.

Read the original article on Health.com.