Heartburn is a burning feeling in the middle of the chest, caused by stomach acid travelling up towards the throat. It often comes with a sour taste and tends to be worse after eating, when lying down or when bending over. What you eat matters, but so do the size of your meals, when you eat them and a few everyday habits.
Foods and drinks that commonly trigger heartburn
- coffee and other sources of caffeine
- alcohol
- chocolate
- fatty and fried foods
- spicy foods
- tomatoes and citrus fruits
- mint
Triggers differ from person to person. You do not need to cut out everything on this list. Keep a simple record of what you ate before each bout of heartburn for two or three weeks, and remove only the foods that keep showing up.
Does white bread cause acid reflux?
Bread, white or brown, is not among the foods that health authorities list as common reflux triggers. When bread seems to be the cause, the explanation is usually something that came with it: a large portion, a late meal, or fatty toppings and fillings such as butter, cheese, processed meat or fried food. Pastries and pies are high in fat, which is a recognised trigger.
If you notice heartburn every time you eat bread, test it properly. Eat a small portion plain, earlier in the day, and see what happens. If bread, pasta and other wheat foods regularly cause bloating, tummy pain or diarrhoea as well, mention it to your doctor, because that pattern can point to something other than reflux.
Plain pasta is in the same position. The usual culprits are a large serving and a tomato-based, creamy or spicy sauce.
How to eat to prevent heartburn
- Eat smaller meals, more often. A very full stomach makes reflux more likely.
- Finish eating three to four hours before bed. Lying down on a full stomach is one of the most common causes of night-time heartburn.
- Choose lower-fat options. Grill, bake or steam, and go easy on fried food and rich sauces.
- Go easy on alcohol and coffee if you have noticed they set off symptoms.
- Eat slowly and sit upright while you eat.
Habits that help as much as food
- Lose weight if you are overweight. Extra weight around the middle pushes acid upwards.
- Raise the head of your bed by 10 to 20 cm, so that your chest and head are above the level of your waist.
- Avoid clothes that are tight around the waist.
- Stop smoking.
- Find ways to relax. Stress can make heartburn worse.
- Check your medicines. Some, including anti-inflammatory painkillers such as ibuprofen, can cause heartburn. Do not stop a prescribed medicine without speaking to your doctor.
Medicines for heartburn
A pharmacist can recommend an antacid or an alginate, which are best taken with food or soon after eating. They ease symptoms for a few hours but do not treat the cause. If you need them most days, see your doctor, who may prescribe a medicine that reduces the amount of acid your stomach makes.
Heartburn or heart attack?
Heartburn causes a burning feeling that is linked to meals or lying down and eases with antacids. A heart attack is more likely to cause pressure, tightness or squeezing in the chest that may spread to the arm, jaw, neck or back, with sweating, breathlessness or nausea. If you are not sure, treat it as an emergency: call 10177, or 112 from a cellphone, or go to the nearest emergency unit.
When to see a doctor
- You have heartburn most days.
- Changing your eating habits and pharmacy medicines have not helped.
- Food feels as if it is getting stuck when you swallow.
- You are being sick often.
- You are losing weight without trying.
Long-term heartburn can be linked to a stomach ulcer or a bacterial infection of the stomach, both of which are treatable. For other causes of tummy pain, see why does my stomach hurt.
This article is for general information and does not replace advice from your doctor.
Medically reviewed by the ASAIPA clinical team.
