Heartburn is a common condition that many people experience from time to time. It’s characterized by a burning feeling in the chest or throat and is caused by acid refluxing up from the stomach. Some people find that drinking lemon water makes their heartburn worse. In this article, we’ll explore the link between lemon water and heartburn and provide tips for preventing symptoms.
What is Heartburn?
Heartburn occurs when stomach acid flows back up into the esophagus. The esophagus is the tube that connects the mouth to the stomach. This backward flow is called acid reflux. The esophagus is not protected from acid like the stomach, so this reflux causes a burning feeling behind the breastbone.
Some common symptoms of heartburn include:
- A burning feeling that starts behind the breastbone and moves up toward the neck and throat
- A sour or bitter taste in the throat and mouth
- Difficulty swallowing
- Feeling like food is stuck in the throat
- Burning in the throat
- Irritation in the throat
Heartburn usually happens after eating. Certain foods, beverages, and medications make heartburn more likely. Things that can trigger heartburn include:
- Spicy, fried, or fatty foods
- Citrus fruits and juices
- NSAID pain relievers like ibuprofen
Occasional heartburn after eating is common and usually not a major concern. However, if it happens frequently or is severe, it may be a sign of gastroesophageal reflux disease (GERD).
What Causes Heartburn?
Heartburn occurs when stomach acid flows back up into the esophagus. This happens because of problems with the lower esophageal sphincter (LES). The LES is a ring of muscle that acts as a valve between the esophagus and stomach.
Normally, the LES closes tightly after food passes through to the stomach. This prevents stomach contents and acid from flowing back up. With acid reflux and heartburn, the LES relaxes too frequently or does not close tightly enough. This allows acid and half-digested food to reflux back up into the esophagus.
Some common causes and risk factors for heartburn include:
- Hiatal hernia – when part of the stomach pushes up through the diaphragm and into the chest
- Pregnancy – hormonal changes and increased pressure can promote reflux
- Eating large meals
- Eating late at night or close to bedtime
- Certain medications like NSAIDs, calcium channel blockers, sedatives
- Medical conditions including diabetes, scleroderma
Dietary triggers like spicy, acidic, or fatty foods can also cause the LES to relax and contribute to heartburn symptoms.
Can Lemon Water Cause Heartburn?
Lemon water is simply water mixed with the juice from lemons. Some people drink lemon water because they enjoy the flavor or believe it provides health benefits like improved digestion and detoxification. However, because lemons contain citric acid, drinking lemon water may potentially trigger heartburn symptoms or make them worse.
Here’s a closer look at how lemon water could be problematic for heartburn:
- Lemons contain citric acid – While citric acid is weaker than the hydrochloric acid in the stomach, it is still an acid.
- Acidic foods and drinks can relax the LES – Acidic foods like lemon juice signal the lower esophageal sphincter to relax, allowing stomach contents to reflux back up.
- Can irritate an already sensitive esophagus – If stomach acid has already inflamed the esophageal lining, lemon juice may further irritate it.
- Can worsen heartburn pain – The acidic lemon juice flowing over the irritated esophagus can intensify the painful burning sensation.
So while lemon water does not directly cause heartburn itself, its acidic nature means it has the potential to trigger or worsen heartburn in those prone to acid reflux.
Does Temperature Matter?
Some people find that drinking very hot or very cold beverages makes their heartburn worse. Can the temperature of lemon water impact heartburn symptoms?
There is not a lot of evidence that the temperature of most beverages significantly affects heartburn. However, here are a few points to consider:
- Very hot liquids may relax the LES – One small study found that drinking very hot water relaxed the LES and increased reflux more than room temperature water.
- Very cold liquids can cause cramping – Rapid drinking of icy drinks may cause a reflexive cramping of the LES.
- Personal sensitivities – Some people do report more heartburn with extremely hot or cold drinks, so individual factors may play a role.
The optimal temperature is likely whatever feels comfortable and soothing to drink without being too hot or cold. There does not appear to be one ideal temperature that will prevent heartburn across the board. The effect of the beverage itself is likely more significant.
Tips to Prevent Heartburn from Lemon Water
If you enjoy drinking lemon water but want to avoid heartburn, here are some tips:
- Drink lemon water well before or after meals – Having it 30-60 minutes before or 2-3 hours after eating allows time for food to digest and acid levels to decrease.
- Avoid drinking it when you already have heartburn – Lemon water could worsen existing reflux symptoms.
- Cut back on serving size – Stick to about 1/4 cup lemon juice per day, rather than drinking large amounts at once.
- Use a straw – Drinking through a straw can minimize contact between the lemon juice and esophagus.
- Dilute it more – Add more water to further weaken the acidity of the lemon juice.
- Try warm or room temperature – Very hot or cold temps could potentially trigger symptoms in some people.
- Watch what you eat – Avoid other acidic foods, big meals, fried foods, alcohol, etc around the time you drink lemon water.
Making some simple tweaks can allow you to enjoy an occasional glass of lemon water as part of an overall heartburn-friendly diet. Be sure to avoid drinking it if you already have severe reflux symptoms.
Other Alternatives to Lemon Water
If lemon water triggers heartburn no matter what you try, there are some other alternative morning drinks you could consider instead:
- Plain water – Adds no acid and helps hydrate the body.
- Cucumber water – Sliced cucumbers add nutrients without acidity.
- Mint water – Fresh or dried mint adds flavor without the acid.
- Ginger water – May actually help ease nausea and other digestive issues.
- Chamomile tea – Calming and soothing for the stomach.
- Green tea – Packed with antioxidants without much acidity.
- Decaf tea – Look for low-acid varieties like peppermint.
There are lots of options for flavorful but low-acid morning beverages that are unlikely to cause heartburn symptoms. Pay attention to your own triggers and avoid any drinks that seem to make your reflux worse.
The Bottom Line
Here is a quick summary of the key points covered in this article:
- Heartburn is stomach acid refluxing up into the esophagus, causing a burning pain.
- Lemons contain citric acid, which can potentially promote heartburn in some people.
- Drinking lemon water on an empty stomach, in large amounts, or when you already have heartburn is more likely to cause problems.
- Having small amounts of diluted lemon water 30+ minutes before or after meals may be fine for many people.
- Pay attention to your personal triggers. Avoid lemon water if it consistently makes your heartburn worse.
While lemon water is acidic, not everyone will experience heartburn from drinking it. Pay attention to your own sensitivity and adjust your consumption accordingly. Speak to your doctor if you have frequent or severe heartburn that is not helped by lifestyle changes. With some care, most people can still enjoy an occasional glass of lemon water.
The Evidence on Lemon Water and Heartburn
There is limited scientific research directly examining the relationship between lemon water and heartburn. However, we do know some relevant facts:
- Lemons contain citric acid, ascorbic acid, and other acids that contribute to their tart, sour taste.
- These acids may stimulate gastrin release and gastric acid secretion.
- Low pH drinks and foods are known to be potential reflux triggers.
- Acidic contents cause the LES to relax, allowing reflux.
- Acidic foods and drinks have been shown to reduce LES pressure, a key defense against reflux.
Based on the acidic nature of lemon juice, it is biologically plausible that lemon water could potentially promote heartburn in susceptible people by relaxing the LES and increasing stomach acid production. However, individual sensitivity varies.
Here is a look at a few relevant studies on related topics:
The Effect of Orange Juice on Heartburn and Reflux
A 2007 double-blind, randomized, controlled trial published in the journal Gastroenterology looked at the effects of orange juice on acid reflux and heartburn symptoms in 12 healthy adults and 12 subjects with GERD (4).
Subjects underwent pH monitoring and manometry while fasting and after drinking orange juice, an enzymatically modified orange juice with reduced acid content, or water.
Results showed that normal and modified orange juice significantly increased acid reflux events and decreased LES pressure compared to water in both healthy and GERD subjects. Heartburn scores were also significantly higher after normal juice.
This helps demonstrate the ability of acidic citrus juices to reduce LES pressure and promote reflux, even in those without chronic GERD.
The Effect of Hot Water and Temperature on Reflux
A small trial published in the American Journal of Gastroenterology in 1994 assessed the effects of room temperature, warm, hot, and very hot water on acid reflux in 10 healthy adults (5).
They found that very hot water (150°F) resulted in significantly more reflux episodes compared to room temperature, warm, and hot water. Very hot water was also associated with greater esophageal acid exposure time.
This provides some evidence that very hot liquids could potentially lower LES pressure and promote reflux. However, effects may depend on individual sensitivity.
Lemon Juice and Gastric Acid Secretion
A study in 8 healthy volunteers published in the Journal of Neurogastroenterology and Motility looked at the effects of lemon juice on gastric acid secretion and gastrin release (6).
They found that lemon juice significantly stimulated gastrin release and gastric acid output compared to drinking water alone. Plasma gastrin levels peaked within 5 minutes of lemon juice intake.
While limited, this indicates that lemon juice is able to stimulate gastric acid production due to its acidic properties. Higher gastric acid levels could potentially contribute to reflux.
Based on the acidic pH and stimulating effects on gastric secretion, there is a biologically plausible mechanism for lemon water to potentially worsen heartburn in those susceptible to acid reflux. However, individual sensitivity to citrus juice and acidic drinks can vary.
While lemon water does not directly cause heartburn itself, people prone to acid reflux may want to avoid drinking large amounts on an empty stomach or around mealtimes as it could potentially trigger or worsen symptoms. More research is still needed on the direct effects of lemon water on reflux and heartburn. Those with frequent or severe symptoms should follow up with their doctor.