Heartburn, gastro-oesophageal reflux among causes

By Cristiano Antonino On Mar 29, 2023

Heartburn, or acidity of the stomach, is a very common annoyance that manifests itself more often after the age of 50

The causes can be very different: poor diet, stress, specific diseases such as gastro-oesophageal reflux.

What are the remedies for heartburn, and what foods are best avoided to avoid suffering from heartburn?

What is heartburn?

Heartburn (or pyrosis) is a discomfort felt in the chest, behind the sternum, which can be perceived in association with the sensation of acidity.

The discomfort – in some cases pain – radiates from the stomach, to the chest, to the area between the shoulder blades, and in some cases also reaches the throat and jaw.

The pain may worsen when bending forward, so that the stomach is compressed, or in a supine position, e.g. lying down immediately after eating, as lying down makes gastro-oesophageal reflux more likely, a disorder characterised by contents from the stomach rising into the oesophagus, resulting in a retrosternal burning sensation and regurgitation.

Heartburn: the causes

There are several reasons that can cause heartburn:

Poor continence of the diaphragm (the muscle that separates the chest from the abdomen) and the oesophago-gastric junction (the point of passage between the oesophagus and the stomach), which fail to prevent stomach contents from flowing back up into the oesophagus (gastro-oesophageal reflux);
Excessive production of acidic juices by the stomach;
Increased pressure on the stomach, e.g. due to overweight in the abdomen or pregnancy;
Irregular, too fatty, too large meals resulting in slow emptying of the stomach;
The intake of certain foods, spices, acidic foods, alcoholic beverages, coffee, perhaps before going to sleep;
Taking certain medications, especially non-steroidal anti-inflammatory drugs (NSAIDs);
Smoking;
Stress;
Radically altered diet in a short time.

Heartburn: what to eat

As far as diet is concerned, those with heartburn should avoid:

wine and spirits;
spicy foods;
fried foods;
sausages;
liquids that are too hot
fizzy drinks;
caffeine and caffeinated drinks;
spices in large quantities.

Limit, on the other hand:

tomatoes;
citrus fruits;
milk and fresh dairy products, including yoghurt;
red meat;
vinegar;
pickles;
cocoa.

However, it is important to specify that everyone reacts differently to eating the same foods, and what causes heartburn for one person may not give another heartburn.

Heartburn: remedies

Heartburn may be occasional (e.g. it may appear after a large meal).

Or it may occur frequently, e.g. after every meal or several times during the week, and could therefore be a sign of a more complex disorder.

If the disorder persists or occurs frequently, a gastroenterological examination should be carried out.

The gastroenterologist will assess the need for further tests, suggest any lifestyle changes that may be appropriate, and provide indications for treatment, which – in the case of gastro-oesophageal reflux, for example – may include specific drugs such as antacids, proton pump inhibitors (drugs that block acid production in the stomach) or prokinetic drugs.