What fruits make heartburn worse?

If you're one of the 60 million Americans who get heartburn at least once a month, you're all too familiar with the fiery sensation behind the breastbone. If you're lucky, your heartburn symptoms only last a few minutes. For most people, however, heartburn can linger for hours. "What happens during heartburn is that stomach acid is backing up into your esophagus," says Steven Lamm, MD, an internist and preventive heCity alth expert, faculty member of the NYU School of Medicine in New York and author of No Guts, No Glory.

But not all foods affect everyone in the same way. You may benefit from keeping a food diary and looking for clues as to what may be causing your heartburn symptoms. Start by knowing these common heartburn trigger foods.

Many people find that eating citrus fruits, such as oranges, grapefruits, lemons, limes, and pineapples, can trigger heartburn symptoms. That's especially true if you eat citrus fruits on an empty stomach. The problem is that citrus fruits are highly acidic, and heartburn symptoms can stem from having too much acid in your stomach — think of these foods as fueling the fire. To avoid heartburn, skip citrus fruit juice, too.

Tomatoes also have a lot of acid, making them a common heartburn trigger. It's not just the tomatoes you eat in your salad or slice on your sandwich, but also the tomato sauce on your pizza and pasta as well.

Although the aroma of foods loaded with garlic can make your mouth water, if you're prone to heartburn you may want to skip it.

Coffee is a common heartburn trigger food. You might be able to get away with a cup or two of coffee in the morning, but it's important to determine what your personal limit is. And remember that tea and many soft drinks also have caffeine, so you may want to consider cutting back on these beverages as well in order to avoid heartburn.

"It's typical for alcohol to trigger heartburn," Lamm says. That includes beer, wine (especially red), and hard liquor. "Some people may have more trouble with hard liquor than they might with wine or beer," he adds. But even beer with low-alcohol content can trigger heartburn in some people. Eating a heavy meal or rich foods with a cocktail or wine can compound the problem.

A small piece of chocolate on occasion may not ignite the flame of heartburn, but a huge chunk of chocolate candy or rich chocolate mousse for dessert could trigger heartburn symptoms and leave you wishing you hadn't indulged. Try to limit chocolate to special occasions and small bites if you suspect it's a heartburn trigger for you.

Here's an entire category that can cause heartburn symptoms: spicy foods. Some of the biggest offenders are dishes loaded with hot peppers and hot sauces. This is because strong spices can irritate your stomach lining, Lamm explains. But that doesn't necessarily mean that all dishes marked "hot" or "spicy" are off limits. You might be able to tolerate spices in small amounts without causing heartburn. Try dialing down the heat or opt for foods marked "mild."

Like garlic and spices, onions trigger heartburn symptoms in many people, and raw onions — a highly acidic food — often provoke the worst reaction. You may be able to get away with small amounts of onions if you cook them thoroughly to reduce their potency. Another option that works for some people is using a sweeter variety of onion, such as Vidalia, because they aren't as potent.

Fatty foods sit in your stomach longer, and the longer the food sits, the greater the chance that digestive juices will back up into your esophagus and cause heartburn. Besides the obvious fried chicken, French fries, and fish sticks, you should also stay away from high-fat foods like avocados, cheese, ice cream, and nuts.

Peppermint is generally thought to settle a queasy stomach, but it's also one of the most surprising heartburn triggers. One possible explanation is that the menthol in the peppermint relaxes the lower esophageal sphincter, the circular band of muscle around the bottom part of the esophagus that separates it from the stomach. When this band relaxes, stomach acid can more easily flow back up, causing heartburn.

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Heartburn is a burning feeling that many people experience occasionally. Avoiding certain foods, such as fatty foods and alcohol, can help with the symptoms.

If a person experiences heartburn regularly, they should speak to a doctor, as they may have an underlying condition.

Keep reading to learn more about the foods that cause heartburn, as well as some remedies that may help.

Share on PinterestSpicy foods and fatty foods can both cause heartburn.

More than 60 million people in the United States experience heartburn symptoms at least once a month. Doctors also refer to heartburn as acid reflux, acid indigestion, or gastroesophageal reflux.

Heartburn occurs when the acid in the stomach flows back up into the esophagus, or food pipe. Some people describe this as a feeling of burning discomfort that starts behind the breastbone and moves up toward the neck and throat. There may also be a bitter taste in the throat or a feeling of pressure.

The symptoms can be present for several hours, and they can feel worse after eating certain foods.

According to a review in Gastroenterology & Hepatology, heartburn is most common among young and middle-aged females. The authors note that other physical and psychological conditions are also commonly present and may contribute to heartburn.

These include:

• depression
• anxiety
• stress
• digestive disorders, such as irritable bowel syndrome (IBS)
• helicobacter pylori infection

Gastroesophageal reflux disease

Many people have occasional heartburn. However, more frequent symptoms may mean that someone has gastroesophageal reflux disease (GERD).

Usually, a muscular valve at the lower end of the esophagus prevents stomach acid from entering it. In people with GERD, this valve — called the lower esophageal sphincter — relaxes too frequently.

Prolonged exposure to stomach acid can cause complications if a person does not receive medical treatment. For instance, in the long term, untreated GERD can lead to Barrett’s esophagus and esophageal cancer. Doctors often prescribe medications called proton pump inhibitors (PPIs) for GERD.

Anyone with frequent or prolonged heartburn symptoms should see a doctor. GERD symptoms may be similar to those of heartburn, but people can also experience hoarseness, vomiting, or weight loss.

Learn more about GERD here.

Some foods and drinks can trigger heartburn symptoms or irritate the esophagus.

As everyone may react differently to foods, a person should try monitoring their symptoms after eating different foods to determine which may be causing heartburn.

The following foods and drinks are those that commonly cause heartburn.

Spicy foods

Spicy foods can irritate the stomach and may cause heartburn. Chili peppers contain capsaicin, which research suggests causes delayed gastric emptying and may promote reflux.

Spicy foods from takeaways or restaurants often also contain onions and fats that can cause heartburn.

It may be preferable to prepare curries and chili dishes at home from scratch and use milder spices or fresh herbs instead. People can also try adding coconut milk to curry to make it less spicy.

Fatty and fried foods

Experts advise that fatty and fried foods take longer to digest, increasing the pressure on the esophageal sphincter. The sphincter then opens, and acid flows into the throat.

Foods to consider excluding from the diet include:

• fries
• burgers, takeouts, and fast foods
• heavy or creamy dressings, such as mayonnaise
• fried bacon, chicken, and sausages
• potato chips
• donuts
• pastries
• full fat dairy foods

Acidic foods

According to the American College of Gastroenterology (ACG), acidic foods such as tomatoes and citrus fruits can irritate the lining of a damaged esophagus.

People can try avoiding lemons, oranges, and grapefruits, opting for other fruits, such as berries, melons, and strawberries, instead. People should also limit their consumption of orange juice and other citrus juices.

Either a pesto sauce or olive oil and fresh herbs can replace a tomato-based sauce to make a pasta dish less acidic. Alternatively, adding a little baking soda to tomato-based sauces can help neutralize some of the acids.

Carbonated drinks

Sodas contain gas that can force open the lower esophageal sphincter and cause a person to burp. The sugar in sodas can ferment in the stomach and cause more gas and bloating.

People should avoid carbonated and sugary drinks and drink water or dilutables instead.

Meat

In a 2018 pilot study, participants who ate vegetable protein had less acid reflux an hour after the meal than those who ate meat. According to the study, saturated fats and animal protein may negatively affect digestive acid and hormones, as well as the constriction of the esophageal sphincter.

People may experience more symptoms when eating fatty meat or meat fried in fats. However, they may be able to eat lean meats, such as turkey and chicken, as part of their diet.

Alcohol

Research in 2009 indicated that alcoholic beverages relax the lower esophageal sphincter and stimulate gastric acid secretion. In the study, beer, red wine, and white wine all caused reflux.

Some people may experience symptoms after one alcoholic drink, but others may tolerate moderate amounts. A person will need to work out their own limits.

Peppermint

Peppermint oil relaxes the lower esophageal sphincter and can cause reflux and heartburn. When doctors give people peppermint oil for symptoms of IBS, it is enteric coated, which allows it to bypass the esophagus and enter the stomach where the body breaks it down.

However, people should watch out for peppermint in teas, candies, and mouthwash.

Chocolate and coffee

According to the ACG, chocolate can be a trigger for heartburn. If this is the case, a person may wish to avoid:

• chocolate bars
• chocolate candy
• chocolate-based drinks, such as hot chocolate, mocha, and cocoa

Research on the effects of coffee on reflux has produced conflicting results. The authors of a 2015 review suggested that certain factors, such as the type of coffee a person drinks and whether they have an empty stomach, may influence coffee’s effects. People should monitor their symptoms to decide whether they can tolerate caffeine.

Alongside making dietary changes, some people may need treatment to reduce their symptoms.

Medical treatment

People can buy antacids such as Gaviscon or Rennies for the symptomatic relief of heartburn.

Doctors may sometimes prescribe PPIs such as omeprazole (Prilosec). However, the long-term use of these drugs carries risks.

PPIs reduce acid and can lead to a condition called hypochlorhydria. People with hypochlorhydria do not have enough stomach acid to perform essential bodily processes.

The hydrochloric acid that the stomach produces helps absorb essential vitamins and minerals, as well as preventing the overgrowth of bacteria in the small intestine.

According to some research, the long-term use of PPIs may cause small intestinal bacterial overgrowth (SIBO). In this condition, someone may experience symptoms of bloating, steatorrhea (fatty stool), and vitamin deficiency.

Natural remedies

Some people with heartburn may prefer to try using natural remedies.

A 2016 study on heartburn tested the efficacy of a natural remedy containing olive leaf and prickly pear extract against a placebo. The formulation, called Mucosave, almost abolished symptoms in participants who used the product for 2 months. However, further research is necessary to confirm these effects.

Mucosave is an ingredient in some products available for purchase online.

According to a 2018 review, natural remedies such as ginger, aloe vera, and turmeric may also be useful for digestive issues, but they are not well-studied for heartburn.

People with heartburn can also take steps at home to improve their symptoms. The ACG and the International Foundation for Gastrointestinal Disorders advise:

• reaching or maintaining a moderate weight
• stopping smoking, if a smoker
• eating in stress-free surroundings
• avoiding eating for 2–3 hours before sleep
• staying seated for a time after eating
• avoiding physical exertion after a meal
• seeing a doctor if self-medicating for heartburn two or more times a week

Learn more about remedies for heartburn here.

As some foods and drinks can trigger heartburn symptoms, eliminating them from the diet may help people prevent heartburn.

People respond differently to foods, but spicy and greasy foods, alcohol, and caffeine often contribute to symptoms.

A person can also try eating earlier and avoiding stress while eating. Changing other habits, such as by resting for a short time after eating and quitting smoking, is often also beneficial.

If someone has heartburn symptoms two or more times a week, they should see their doctor, as they may have GERD or another underlying medical condition.