8 surprising heartburn causes you need to take seriously

At some point, you’ll probably feel the burn – heartburn, that is. Around one in five Australians experience regular reflux or heartburn. But although heartburn is common, it’s causes can be tricky to understand, experts say. Here’s what you need to know about heartburn.

If it seems as if more people are dealing with heartburn, it’s because they are. “Heartburn has become extremely common, especially in recent years with a growing number of people who are obese,” says Dr Kristle Lynch, assistant professor of clinical medicine at Perelman School of Medicine at the University of Pennsylvania. One of the primary heartburn causes is obesity, which increases gastric pressure so that stomach contents flow back up into the oesophagus.

The term may sound self-explanatory, but you’ll know it’s happening to you if “you feel a burning midline chest pain or experience some liquid regurgitation (acid reflux),” says Dr Lynch.

Here’s how to tell if your indigestion is actually GORD.

Heartburn may be common, but it’s not something you can brush off. If you try over-the-counter medication (like OTC proton-pump inhibitors) and symptoms don’t improve, that’s not typical. “It may not be heartburn, or it’s heartburn that’s not responding to medication,” says Dr Lynch. Choking on food, vomiting and unexplained weight loss are also worrisome; talk to your doctor. If it’s severe and you suspect it may be a heart attack, head to the ER.

Here are 8 chest pains you might mistake for a heart attack.

Yes, it’s easy to throw heartburn medication at the problem and wait to feel better. Some people just live with the pain, thinking this is something that just happens after eating. That’s unwise, says Dr Lynch: Over time, acid reflux causes damage to the lining of the oesophagus and can lead to Barrett’s oesophagus, a condition in which cells of the lining of the oesophagus develop abnormalities. “Barrett’s can eventually turn into oesophageal cancer. Though most patients will never develop cancer, it’s so scary and morbid that it’s a high concern,” says Dr Lynch.

Although some research suggests that chewing sugar-free gum for a half-hour after a meal can decrease reflux, mint can have the opposite effect. In general, peppermint is a trigger for some people because it relaxes the lower oesophageal sphincter, allowing juices to bubble back up. If you’re going to try the chewing-gum trick, start with a non-mint flavour.

You thought you were being healthy with your brown-rice bowl packed with broccoli and black beans, so why do you feel awful now? Although it’s a rarer trigger, “a high-fibre meal empties more slowly out of the stomach,” says Dr Lynch. And one of the more common heartburn causes is food that sits around longer in the digestive tract.

You’ve likely heard that acidic foods like tomato-based pasta sauce, tomato juice and raw tomatoes can be common heartburn causes for some people. But you may not have realised that bottle tomato sauce (ketchup) is also a potential culprit, says Dr Lynch. Even the smaller amounts that are typically eaten with a meal could be a problem.

Or, rather, it’s the loss of gravity’s assistance when you lie down after you eat that is among the heartburn causes, according to Dr Lynch. Sitting up allows food and digestive juices to move the correct way; lie back and they can move upward, leading to heartburn. Try to finish your last meal two to three hours before bed.

It’s like a heartburn trifecta. Dinner is often the biggest meal of the day, and eating heavy loads of food slows digestion (trigger one). Then we lie down to go to sleep (trigger two). And people are generally more sensitive to pain at night (trigger three). “Everything is quiet, and you’re more aware of the sensation of pain,” says Dr Lynch. Big, late dinners are like three heartburn causes in one. What can help is eating smaller meals, finishing up eating a few hours before bed, and using a wedge pillow or risers for the head of your bed to keep gravity’s pull working for you while you snooze, she says.