Heartburn Relief

By Kara Carper, MA, CNS, LN
March 25, 2024

10% of Americans have an episode of heartburn every day. Overall, acid reflux or GERD (gastroesophageal reflux disease) affects up to 35% of the population. As a result, acid-blocking medications are the third top-selling type of drug in America today.

If you have irritating and uncomfortable bouts of heartburn and acid reflux, read on for ideas on how to resolve it!

What Is Heartburn & What Causes It?

Heartburn is the painful burning you feel in your chest around the area of your breastbone. Many people use the terms heartburn, acid reflux, and GERD (gastroesophageal reflux disease) interchangeably, but there are some slight differences between these terms.

Heartburn is the sensation of what you feel with acid reflux - that slight burning sensation in the chest or a bitter acid taste in the mouth. According to the Mayo Clinic, occasional heartburn is common. It's very unpleasant though, so we'll help you find relief!

Acid reflux is when your sphincter muscle at the end of your esophagus relaxes at the wrong time or doesn't close all the way, which allows stomach acid to come back up the esophagus. The feeling of acid reflux symptoms is heartburn.

GERD (gastroesophageal reflux disease) is when the backflow of stomach acid into the esophagus becomes chronic. GERD is a more serious form of persistent acid reflux symptoms because it's happening on a regular basis and causing damage to the body overtime. Stomach acid isn't meant to be in the esophagus, so those delicate tissues can get irritated, become inflamed, and cause other issues, like ulcers or a narrowing of the esophagus causing a difficulty swallowing.

Heartburn And Acid Reflux Symptoms:

Heartburn symptoms can be a painful or burning sensation that radiates up from the stomach to the chest and throat. Typically folks experience this at night, especially after eating a large meal or when lying down or bending over putting pressure on the stomach.

Other symptoms include hoarseness, feeling like food is stuck in the throat, wheezing, asthma, sour or bitter taste in the mouth, and bad breath.  

One thing to note is that chest pain can also be a symptom of a heart attack. If you are unsure of the cause of your chest pain and have other heart attack symptoms, call 911 right away to get yourself checked out. It's better to be safe and get looked over by a medical professional.

Is Heartburn Caused By Too Much Stomach Acid?

Most assume heartburn and acid reflux symptoms are from TOO MUCH stomach acid when the opposite is true. In fact, Dr. Jonathon Wright, an expert on GERD and gastroesophageal reflux at Tahoma Clinic, reported that in 25 years of conducting tests, he found very few people with excess stomach acid. He states, "When we carefully test people over age 40 who are having heartburn, over 90% of the time we find low stomach acid production."

So, you'd think that too much acid is what's overflowing into the esophagus causing acid reflux. What's actually going on in the body is the lower esophageal sphincter mentioned earlier creates this little doorway between your esophagus and your stomach. It's supposed to stay closed, but when it gets cracked open even a little bit, it leaves room for things to come up that aren't supposed to. The burning is that little bit of acid coming up and creating havoc in that esophagus.

So what keeps that door closed? We need enough stomach acid to keep that door closed. When we don't have enough stomach acid, that's what causes less pressure in your abdominal space and it allows that door to fall open just a little bit.

Sufficient stomach acid is important to reduce acid reflux symptoms. The right balance of stomach acid will help keep that lower esophageal sphincter working properly.

Is Heartburn Caused By Food?

The most common assumption for the cause of heartburn is types of food. You'll often see a list of culprits like spicy food, tomatoes, chocolate, fried food, fatty foods, alcohol, carbonated beverages, and coffee.

So What Causes Heartburn?

Along with your stomach acid balance, it's possible that the above foods could cause acid reflux issues and it's important to pay attention to what trigger foods might be causing it for you.

What we have found in clinic is the biggest triggering foods for acid reflux issues are ones with sugar and flour. Think foods like chips and soda. Or pizza and beer. Candy bars and cookies. Pasta with bread. Cereal and milk. And guess what, many of these trigger foods are part of the common American diet.

The common ingredients in these certain foods and beverages are sugar and/or flour.

To find relief from heartburn and acid reflux, look at foods you consume with sugar and flour, and reduce or even eliminate your sugar intake.

Why Does Sugar Cause Acid Reflux?

First, let's look at how sugar and high carbohydrate foods are digested. Sugar is meant to be broken down and digested in the small intestine. This happens when the pancreas releases enzymes that break down starches into sugar. When the pancreas is bombarded with too much sugar from processed foods, it cannot produce enough of these enzymes to break it all down.

Remember that our bodies are not designed to handle a lot of sugar and high carbohydrate foods. On average, Americans ate 28 teaspoons of sugar per day in 1900. That increased to an average of a half pound of sugar PER DAY in 2012. Recent research from 2023 recommends dietary guidelines for limiting sugar to no more than 6 teaspoons of added sugar per day to reduce the risk of poor nutritional side effects.

Sugar and high carbohydrate foods also promote bacterial overgrowth which can suppress stomach acid and can trigger acid reflux. Too little stomach acid impairs the body’s ability to digest and absorb sugar and carbohydrates. It’s a vicious cycle.

Poor digestion from the lack of stomach acid can cause undigested food to push on the lower esophageal sphincter (LES) which causes it to relax – this relaxation of the LES allows backflow from the stomach to leak into the esophagus – both undigested food and acid.

As mentioned earlier, the esophagus is very delicate and isn’t supposed to come into contact with strong stomach acid and this causes the burning sensation and discomfort. If this happens over and over again, the LES can become weak which increases the likelihood of more frequent reflux symptoms and could lead to the more chronic version of gastroesophageal reflux disease, GERD.

What About Acid Reflux and Heartburn Medications?

It can be overwhelming and maybe even scary to consider giving up some of your favorite foods . You may even be thinking to yourself that it would just be easier to keep taking your acid-blocking medication instead of changing your diet. After all, this is the most common treatment used for gastroesophageal reflux disease, or GERD.

Heartburn medications like Tagamet®, Pepcid® and Zantac® neutralize stomach acid that is already in there. Other brands used to treat heartburn are Prevacid®, Protonix®, Prilosec®, Nexium® and Aciphex® which block the stomach's production of acid. 

While treating acid reflux with these medications may give you some temporary relief, the problem with this approach is that your body needs stomach acid to stay healthy and to digest food. You also need stomach acid to absorb important nutrients like calcium, magnesium, iron, zinc, vitamin B12 and vitamin D.

When you're on acid reflux medication long term, other serious issues arise such as osteoporosis, anemia, depression, fatigue, IBS, and even nerve damage and dementia, especially in the elderly.

However, people are not often aware of these risks and take acid reflux drugs daily, sometimes for decades, though the medications often call for use of six to eight weeks max. Some doctors even recommend that their patients be on these acid blockers for life. 

Does that sound familiar? Time for a healthier approach. 

Multi-Step Approach For Heartburn Relief

While heartburn is common, it doesn't mean it's normal and you don't have to suffer through it. Here is a quick run through of the steps we will talk about today:

1. Start by reducing the amount of added sugars and processed foods.
2. Remove the gluten or other food sensitives that are harming your gut lining.
3. Replace processed carbohydrates with nutrient dense fruits and vegetables (cooked rather than raw to start if easier on your digestion).
4. Repopulate your good bacteria and natural stomach acid with fermented foods and probiotics.
5. Take time to chew your food to help with digestion.

Bonus tip: get some extra help with supplements! Heal the gut lining with l-glutamine, add in some digestive enzymes to give that digestive tract some extra help, or look at other recommended supplements to support your digestive tract.

Step 1. Reduce Sugar Intake and Processed Food

Consuming sugar can exacerbate acid reflux and GERD symptoms, so making lifestyle adjustments to include more whole, balanced meals and snacks will help healing your gut. Look to create meals with an animal protein, healthy fat, and nutrient dense carbohydrates. When you look to whole foods, you are naturally creating a diet removing sugar intake.

What To Replace Your Sugar Laden Foods With:

Is cereal (often even the healthiest versions are filled with sugar) with milk a typical breakfast for you?

• In its place, try eggs and spinach cooked in butter with a piece of fruit.

Wondering what to do on Friday nights after work without pizza and beer?

• Replace that sugar-laden beer with a glass of wine and your pizza (you might be surprised at how much sugar is in that pizza!) with a dinner of steak, potato with butter, and green beans instead.
• If you don't care for wine, your new beverage could be a sparkling water with fresh-squeezed lemon. Throw in some fresh blueberries for added sweetness.

When your blood sugar gets low at work and you feel those mid-morning cravings approaching or those afternoon energy dips, don't reach for the candy dish or visit the vending machine. Try reducing your sugar intake with these ideas:

• Bring a healthy snack of almonds, string cheese, and an apple to work as an alternative for when you feel your blood sugar dip.
• Have a stash of healthy snacks in your home office or in your purse when you're on the go.

Do you feel pressure at restaurants to eat what everyone else is eating?

• Instead of partaking in the bread basket right away, order a side salad.
• Avoid pasta-centered meals or batter-covered proteins and look for protein that is broiled, grilled, baked or seared.
• Ask for rice or potato, instead of bread.

Step 2. Remove The Gluten & Other Triggering Foods

Remember above, we said sugar and/or flour are the two main food types to cause acid reflux. Gluten is a protein found in flour and it is estimated that one in three people have a gluten sensitivity. If you are one of those people and you have heartburn, because gluten is likely a huge factor in contributing to your symptoms, you will likely continue to have persistent acid reflux symptoms until gluten is removed from your diet.

Gluten is found in wheat, oats, barley and rye and many find that these are triggering ingredients...finding products without these grains can sometimes help remove acid reflux symptoms.

You may have other food sensitivities that are causing damage to your digestive tract and it would help to identify trigger foods, which will help in preventing acid reflux.

Trying an elimination diet for a few weeks with a food diary can help you identify trigger foods that are causing your body harm... our registered and licensed dietitians and nutritionists know how to walk you through that process. For more information on trigger foods listen to this midweek segment of our podcast called How to Determine Food Triggers for Digestive Issues - Ask a Nutritionist.

Step 3. Replace Your Carbohydrate Sources

We need carbohydrates. They give us energy and much needed nutrients. But you do want to swap your sources if you find you are eating a diet of processed carbohydrates containing added sugar with poor nutritional value.

Eat lots of carbohydrates from vegetables and fruits instead of eating those sugar filled bread, pasta, cereal, crackers and baked goods. Since raw foods can be more difficult to digest, try cooking your vegetables and fruits for awhile as you soothe your symptoms with these other steps.

Step 4. Repopulate Your System With Healthy Bacteria

It's common to have a deficiency of good bacteria in the gut, especially if you've ever taken antibiotics. You can supplement with a probiotic, but there are also real, whole food options for increasing the good bacteria in your gut that are very helpful for soothing heartburn.

Incorporating more fermented foods into your diet can help balance the good bugs in your gut. Think probiotic-rich foods like whole-milk yogurt or kefir, sauerkraut, kimchi, fermented veggies, and kombucha (look for the low sugar flavors!).

Step 5. Take Time To Chew Your Food

It might seem like a silly step, but digestion actually begins in the mouth with our saliva. Breaking down your food before it becomes stomach contents assists the whole process.

Making sure you ENJOY your food is an important part of that process too, so take a moment to eat slowly and chew carefully to help the body break down all your delicious grub.

In fact, we have a midweek segment of our podcast that dives into this very topic. Give a listen to this episode Chewing Your Food - Ask a Nutritionist

Bonus Step: Supplements To Help With Heartburn

Often, when clients adopt a diet removing sugar, remove trigger foods, and follow these five steps, the burning sensation of heartburn goes away on its own.

If you've followed these five steps and are still struggling with heartburn and acid reflux, we'd suggest learning about our recommended supplements to help with heartburn and treating acid reflux.

TOP THREE SUPPLEMENTS TO HELP WITH HEARTBURN - in this article we walk you through three great options for relief from acid reflux.

Is gluten one of your trigger foods for acid reflux symptoms?
Learn how to go gluten-free in our self-paced class Going Gluten Free The Healthy Way

Take Online Class For $25 

Additional resources:

READ: SUPPLEMENTS FOR SUGAR CRAVINGS - if you struggle with sugar cravings (sometimes it's not just sugar, it could be other foods you are craving), we discuss how to avoid consuming sugar and what supplements might help you as you battle sugar cravings and navigate a diet without sugar.

LISTEN: Is Your Heartburn Back?

READ: What Is The Microbiome? What Does It Do And How To Keep It Healthy

References:

https://www.mayoclinic.org/diseases-conditions/heartburn/symptoms-causes/syc-20373223