Heartburn: symptoms, causes & treatment

Heartburn, or “pyrosis”, to use the medical term, describes a burning feeling in the upper abdomen or behind the breastbone that often radiates up to the throat. The burning sensation occurs when stomach acid rises into the oesophagus and irritates its mucous membrane. These are the most common symptoms of heartburn:

• Nausea: In addition to the burning sensation, many sufferers also experience an unpleasant feeling of fullness. Heartburn is frequently associated with nausea, which is occasionally accompanied by the urge to vomit.
• Sore throat: If stomach acid enters the throat, it irritates the mucous membranes, which can often cause a sore throat.
• Sufferers may additionally experience a sour taste in the mouth, acid burps, pressure in the upper abdomen, coughing or hoarseness.

Occasional heartburn is widespread and usually harmless. However, if the symptoms last for a long time or recur regularly, this may indicate a reflux issue. Seeking guidance at an early stage can protect your health.

Heartburn occurs for a variety of reasons. In some people, it is their body reacting to certain triggers, while in others, the burning sensation indicates an illness. Pyrosis is not always a standalone problem, but instead can often reflect complex relationships within the body. Other causes and risk factors include:

• Alcohol: Alcohol weakens the sphincter between the oesophagus and the stomach, meaning that stomach acid flows back into the oesophagus more easily.
• Posture: Spending long periods of time lying down, stooping or engaged in physical exertion increases the pressure on the stomach. When you lie down, stomach acid rises into the oesophagus more easily – which is why heartburn often gets worse at night.
• Stress: Persistent stress throws your stomach out of balance, causing it to produce more acid. Heartburn is often accompanied by acid burps.
• Diaphragmatic hernia: If you have a diaphragmatic hernia, the opening between the chest and the abdomen widens, causing part of the stomach to slip through it. The sphincter loses its natural support, which promotes heartburn and reflux.
• Eating habits: Eating large, fatty or late meals can lead to heartburn. Being overweight is also a common cause. Small portions are often tolerated better than large meals.
• Medication: Certain medications can reduce sphincter pressure or irritate the mucous membranes. If taken long-term, they can additionally weaken the mucous membrane’s natural protective mechanisms, making it more susceptible to gastric acid. 

When and how often does heartburn occur? This is the first clue to what might be causing it. Pay attention to other signals from your body as well. If you’re also experiencing stomach or intestinal problems, it’s worth taking a closer look at this. Pay attention to what you eat: make a note of whether certain foods – for example, coffee, fatty foods or spicy dishes – cause issues. Sometimes heartburn is caused by a food intolerance. Your doctor can perform a test to investigate whether this is the case.

Alongside tiredness, back pain and nausea, heartburn is also one of the most common symptoms during pregnancy. Heartburn in pregnant women is primarily caused by hormonal fluctuations. The hormone progesterone relaxes the muscles throughout the body, including the sphincter between the stomach and the oesophagus. Heartburn and frequent burping are possible as early as the first trimester of pregnancy. The longer the pregnancy lasts, the more frequently women suffer from heartburn. Heartburn is one of the most common complaints during pregnancy, particularly in the third trimester, when the growing child takes up more space in the abdominal cavity. As a result, the uterus presses against the stomach and increases the likelihood of gastric acid flowing back into the oesophagus. It’s worth noting that heartburn during pregnancy usually occurs intermittently and often disappears completely after the birth.

A balanced diet can help to prevent heartburn or alleviate existing complaints. Certain foods irritate the stomach more, while others bind stomach acid and have a calming effect. These recommendations can help:

• Starchy foods: Potatoes, bread and oats are good for heartburn, as they bind excess acid in the stomach, soothing the stomach and often reducing the unpleasant burning sensation.
• Alkaline diet: Alkaline foods often ease heartburn because they do not place additional strain on the stomach. Low-acid fruits and vegetables such as bananas, pears, cucumbers or green vegetables are particularly recommended.
• Mild foods: Spicy, heavily seasoned or very fatty foods generally irritate the stomach mucosa and intensify the burning sensation. Mild and easy-to-digest foods soothe the stomach and usually prevent irritation of the mucous membranes and heartburn.
• Drinks: Your chosen drink can also have an impact. If you have heartburn, you should avoid alcohol and caffeinated drinks. Carbonated drinks also usually trigger acid reflux.

There is no one-size-fits-all way to ease heartburn, and there are no unequivocal bans on individual foods. However, eating habits can offer good insight: when and how much you eat, your body weight and the quality of your nutrition play an important role.

Nutrition is only part of the solution: day-to-day habits also influence how often heartburn occurs. Often, even minor changes are enough to ease the discomfort of heartburn in the morning or after eating. The following measures have a positive impact:

• A healthy body weight makes things easier on the stomach and reduces pressure on the oesophagus. Studies show that weight loss can significantly alleviate symptoms.
• Avoiding nicotine improves the closure mechanism between the stomach and the oesophagus.
• Schedule your last meal of the day for at least three hours before going to bed.
• Elevating your head when sleeping makes it easier for stomach acid to drain in the right direction.
• Regular meditation reduces stress. Other mindful relaxation and breathing exercises can also noticeably reduce stress.
• Tea: certain teas can calm heartburn. Recommended varieties include chamomile, fennel and lemon balm. Warm, still water also soothes the stomach.

Every body reacts differently to certain foods, so pay close attention to which foods do you good and which cause you issues. Consciously monitoring your symptoms will help you to adapt your diet to your individual needs and get your heartburn under control long-term. Take targeted steps to manage stressful situations. If you experience frequent heartburn that persists despite lifestyle adjustments, you should see your doctor.