Louise Chang, MD
You know it all too well. Heartburn. That fiery sensation
that grabs hold of your lower chest after you eat something you know you
shouldn't have. What often follows is that sour or bitter taste of acid reflux
in your throat and mouth that can last minutes (if you are lucky) or hours (if
you are not).
Yes, millions of us are familiar with the discomfort of heartburn, a
condition in which stomach acids back up into the esophagus. The good news is
that heartburn is largely avoidable if you steer clear of the top 10 heartburn
foods. It also helps to avoid certain classic heartburn-inviting
From coffee and liquor to tomatoes and grapefruit, experts tell WebMD that
certain foods are known heartburn triggers.
Here's what you need to know about the top 10 heartburn foods.
Oranges, grapefruits and orange juice are classic heartburn foods. "These
are very acidic," says Robynne Chutkan, MD. Chutkan is the founder of the
Digestive Center for Women in Chevy Chase, Md. and a gastroenterologist at
Georgetown Hospital in Washington, D.C. "As a result of being so acidic," she
says, "they are likely to cause heartburn, especially
when consumed on an otherwise empty stomach."
While they might be chockfull of healthy nutrients like lycopene, Chutkan
tells WebMD that tomatoes are also highly acidic and likely to cause heartburn
in those who are prone to it.
The acid antidote may be a sour ball, according to Daniel Mausner, MD.
Mausner is the section head of gastroenterology at Mercy Medical Center in
Rockville Center, N.Y. "Things that promote saliva -- like sour balls -- are
good for acid reflux," he says, "because saliva neutralizes the acid that comes
up from your stomach."
Bonnie Taub-Dix, MA, RD, says, "Some people with heartburn do not do well
with either garlic or onion." Taub-Dix, a spokeswoman for the American Dietetic
Association, is a nutritionist in private practice in New York City and
Woodmere, N.Y. "It's all very individual," she says. For avoiding heartburn,
she offers the following suggestion: "Keep a food log to help you track the
foods that are your heartburn offenders, and try to develop a list of safe
foods." Foods like broiled chicken, baked sweet potatoes, toast, or cottage
cheese, she says, are on the safe side of the heartburn food list.
Pepper, Mexican food, chili, and any other food that is loaded with pepper
or other spices can trigger heartburn, says Deepa A. Vasudevan, MD. Vasudevan
is an assistant professor of family medicine at The University of Texas Medical
School at Houston. He tells WebMD that avoiding heartburn isn't necessarily a
matter of all or nothing. "If spicy food triggers your heartburn, avoid it.
Then slowly reintroduce milder versions of whatever you like."
Chutkan says that while many people think peppermint is soothing for the
tummy, it is actually a heartburn trigger food. Her advice? Skip the
after-dinner mints -- especially after a rich meal. "They may be good for your
breath on a date," she says, "but they are not so good if you are prone to
Peppermint may increase your chances of heartburn because it relaxes the
sphincter muscle that lay between the stomach and esophagus. This allows
stomach acids to flow back into the esophagus.
What do these foods have in common? They are all high in fat, according to
Chutkan. "These foods may not get as much press as acidic foods when it comes
to heartburn," she says, "but they can be major triggers." Here's why: Fat
slows down the emptying of the stomach, so there is more opportunity for a big
distended stomach -- which increases pressure on the esophageal sphincter -- to
make heartburn more likely.
Chutkan says that doesn't mean you can never have those foods again. "Don't
have a cheese plate at the end of a meal," she suggests. "Instead, eat it early
in the day when you are not already full." Remember, a serving of cheese is
roughly the size of two dice.
Wine, beer, or your favorite cocktail can all trigger heartburn, says
Chutkan, especially when they are imbibed with a large meal. "If you have a
meal of steak, creamed spinach, and lobster bisque and then alcohol on top of
that," she says, "you may be in for it."
Taub-Dix agrees. "A glass of red wine may not be a big deal on its own," she
points out. "But if you also have tomato sauce on your pasta and a glass of
orange juice in the morning on an empty stomach, it could be a problem." Like
peppermint, alcohol opens the sphincter, allowing the acid free range.
Coffee, soda, tea, iced tea, and any other food or beverages that contain
caffeine are big offenders. But java junkies don't have to give up their Joe
forever, Chutkan tells WebMD. "It's not 'no coffee ever' if you have heartburn.
It's about cutting down and paying attention to portion sizes. A Starbucks
tall," she explains, "which is their version of a small, is like three cups of
coffee. Some people tell me they drink two cups of coffee a day and that they
get it at Starbucks. That's like six cups a day."
If you have heartburn, you can likely consume a 3- or 4-ounce cup of coffee
each morning with no problem. But if you guzzle coffee all day long, then, yes,
heartburn is a consequence.
Sure, it can be loaded with caffeine, but chocolate can also be a heartburn
food in and of itself. "Pack up all of your chocolate and give it to your
gastroenterologist for safekeeping if you have heartburn," Chutkan says.
Chocolate relaxes the sphincter, allowing stomach acids to flow back into the
esophagus, she says.
"Carbonated beverages cause gastric distension," Mausner says. And if your
stomach is distended, this increases pressure on the esophageal sphincter,
promoting reflux." He tells WebMD that people with heartburn may be wise to
steer clear of pop and other carbonated beverages.
Taub-Dix's advice is to use the above list as a guide to help you figure out
your heartburn foods and heartburn trigger situations. And remember, she
cautions, even if your favorites are not on this list, you don't necessarily
have a free pass. "Too much of any food can trigger heartburn," she says. It's
not just what you eat; it's how much you eat and when you eat it. "Consuming a
large meal right before you lie down," she says, "will likely cause heartburn
even if it doesn't include any of these heartburn foods."
SOURCES:Bonnie Taub-Dix, MA, RD, spokeswoman, American Dietetic Association;
nutritionist, New York City and Woodmere, N.Y.Deepa A. Vasudevan, MD, assistant professor of family medicine, University
of Texas Medical School, Houston.Robynne Chutkan, MD, founder, Digestive Center for Women, Chevy Chase, Md.;
gastroenterologist, Georgetown Hospital, Washington, D.C.Daniel Mausner, MD, section head of gastroenterology, Mercy Medical Center,
Rockville Center, N.Y.
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