Fall Is Fun, Heartburn Isn’t: What Foods to Avoid

Heartburn and acid reflux — they’re synonyms for the same condition that causes you to feel that hiccup-y, burp-y burning feeling in your chest after eating.  

Whether it’s avoiding acidic veggies, like tomatoes and citrus, at your favorite Pacific Northwest farmers market or skipping the nachos at the UW Husky football game, there are ways to prevent heartburn from happening and to reduce the symptoms when they appear.

What causes heartburn?

When stomach acid rises into your esophagus, it moves up through your chest, close to your heart. That’s why the terms “acid reflux” and “heartburn” are interchangeable: The acid moving through your chest (acid reflux) can cause a painful, burning sensation in the middle of your chest, near your heart (heartburn). And it can feel, well, alarming.  

It’s normal for most people to get heartburn every now and then: More than 60 million Americans experience heartburn symptoms once a month, and more than 15 million people have heartburn symptoms each day. If you’re in that second bucket and have chronic heartburn, your doctor may diagnose you with gastroesophageal reflux disease, or GERD.

How does what you eat affect heartburn symptoms?

Burgess Bennett, ANRP, a nurse practitioner specializing in gastroenterology at UW Medicine’s digestive health clinics, says acidic, fried or fatty foods, and alcoholic drinks can relax the lower esophagus or delay the emptying of the stomach’s contents into the small intestine. This contributes to heartburn symptoms.

And during fall and holiday festivities, when friends and family are having potlucks and dinners with all your favorite dishes, it’s important to know which of those foods might trigger — or help — acid reflux.  

Common foods that cause heartburn

Before you approach that holiday meal or pick up something for the potluck, keep an eye out for these typical heartburn culprits:

• Cheeses
• Tomato-based sauces  
• Fatty meats (like bacon, sausage, pepperoni or salami)
• Fast foods and fried foods
• Ultra-processed foods and snacks
• High-acid fruits and vegetables (like oranges and grapefruits)

If you’re worried about spicy food, know that it can cause heartburn symptoms in some people but not in others. Some research suggests that spicy foods can cause or worsen heartburn symptoms, while other studies suggest that spicy foods might actually help digestion. Listen to your body — if you tend to get heartburn after eating spicy foods, it might be your sign to try something on the milder side.  

Common drinks that cause heartburn

You don’t have to opt out of your favorite holiday beverages, but some are more likely to cause heartburn than others, such as:

• Coffee
• High-fat drinks (like milkshakes)
• Carbonated drinks
• Acidic drinks (like lemonade or limeade)
• Alcohol

Foods that can help your heartburn

It can be hard to give up your favorite foods, but if you notice they’re causing heartburn, you can try some of these substitutions:

• Swap red or fatty meat for ground turkey
• Swap tomatoes for pumpkin
• Look for cheeses that are lower in fat, like mozzarella, ricotta or cottage cheese
• Find low-acid fruits like melons, strawberries or bananas 

Adding some broccoli, leafy greens, whole grains and starchy vegetables (like potatoes) to your plate can also help if you’re prone to heartburn. 

Other heartburn prevention tips

It’s not always what you eat; sometimes, what you’re doing while (or before) you eat can increase your likelihood of having heartburn.

Watch your portion size

Portion size also plays a big role in your likelihood of having heartburn. Eating too-large portions and continuing to eat when you’re already full both increase your chance of feeling that dreaded chest pain after you’re done.

“Personally, I put a small portion of food on my plate and wait at least 20 minutes after finishing it to see how I feel,” says Bennett. “There’s no universal amount that someone should or shouldn’t eat to prevent heartburn, but having smaller portions of richer foods can help.”

Competent eating — a practice which allows you to be comfortable and flexible with your eating habits, with a focus on being intentional about when and how you eat — is a great way to prioritize mealtime habits that feel good and keep you full, without being restrictive.

Avoid drinking too much while you’re eating

Bennett says that drinking a lot of liquid — even just water — can make it more likely for you to get heartburn. Adding liquids to the mix can distend your stomach, which can also affect gastric emptying. That’s not to say you can’t have a drink to wash down your meal as you’re eating; just try to avoid that second (or third) refill before you’ve finished your meal.

Save the cannabis for another time

If you enjoy cannabis recreationally, it’s not always wise to use it before a meal. Specifically, Bennett says that using cannabis, eating, and then going to bed can be a major trigger for acid reflux. Many people claim that having cannabis before a meal helps them eat more (or makes the food taste better), but even if that’s true for you, it’s not worth the pain you might feel later.  

Don’t eat right before bed

Generally, it’s important not to have food before bedtime. That midnight snack might lead to 1 a.m. regret.  

“It’s not always what you eat, but also when you eat,” says Bennett. “Try not to have food three hours before lying down. It can make all the difference in the world for heartburn symptoms. The same goes for alcohol.”

Practice diaphragmatic breathing

A surprising way to relieve heartburn is to practice diaphragmatic breathing.

“I recommend it to all my heartburn patients,” says Bennett.

The way it works is simple: Place one hand on your abdomen just below your ribs (where your diaphragm is), and breathe in through your nose, causing your hand to rise. If you’re not used to diaphragmatic breathing, it might take some practice.

“Breathing this way stimulates the vagus nerve and helps manually compress the contents within your stomach,” says Bennett. “It also helps strengthen the diaphragmatic muscle, which can reduce symptoms as well.”

How can medications help with heartburn?  

The pharmacy shelves are full of medications to keep heartburn symptoms at bay or treat them after they appear. Here’s what you need to know about these options.  

Medications taken before eating

If you frequently have heartburn after eating or have chronic heartburn, over-the-counter proton pump inhibitors like omeprazole and famotidine (think Prilosec OTC or Pepcid AC) can be taken before meals to help prevent it. These medications reduce the amount of acid that your stomach produces, which in turn reduces the chance of you having painful acid reflux.  

Medications taken after eating

If you don’t usually get heartburn and it catches you off guard, over-the-counter medications like sodium alginate can help relieve the symptoms.

“Sodium alginate forms a gel raft-like barrier at the top of your stomach, making it a physical treatment for heartburn by preventing the acid from rising into the esophagus,” says Bennett. “It’s extremely safe and effective for heartburn symptoms.”

Chewable calcium carbonate tablets, like TUMS or Rolaids, can also help alleviate heartburn symptoms if taken within an hour after eating, though Bennett says they’re only moderately effective.

(Don’t) feel the burn this holiday season

It’s still possible to enjoy your favorite meals by taking preventive measures, such as being mindful of portion sizes and substituting lower-fat, lower-acid ingredients when needed.

If your heartburn symptoms are persistent or worsen over time, that’s a sign to schedule an appointment with your doctor. It’s possible that your acid reflux could be caused by other conditions that aren’t necessarily due to excessive acid in the esophagus.  

And remember: You don’t have to skip out on holiday meals entirely (or eat something you don’t like). It just might take a few adjustments to your mealtime habits.