Should I eat lemon if I have heartburn?

Introduction

Heartburn is a common problem that many people experience occasionally after eating. It is characterized by a painful, burning sensation in the chest or throat. Heartburn is caused by acid reflux, when stomach acid flows back up into the esophagus. This can happen after eating spicy, fatty, or acidic foods. Some people experience heartburn more frequently due to gastroesophageal reflux disease (GERD). While antacids can provide quick relief from heartburn, making dietary changes is often recommended as well. This includes avoiding trigger foods and eating foods that may help reduce acid reflux.

Some people claim that eating lemons or drinking lemon juice can help with heartburn. Lemons are very acidic, so it may seem counterintuitive that they could help with acid reflux. However, some sources suggest that the acids in lemon juice may provide relief by stimulating the production of stomach acid, which can help digestion. The purpose of this article is to examine the evidence behind this claim and determine if eating lemons is an effective and safe way to treat heartburn.

What causes heartburn?

Heartburn occurs when stomach acid backs up into the esophagus. The esophagus is the tube that connects the mouth to the stomach. At the bottom of the esophagus is a ring of muscle known as the lower esophageal sphincter (LES). The LES acts as a valve between the esophagus and stomach, opening to allow food to pass through to the stomach, and closing to prevent stomach acid from flowing back up.

When the LES relaxes abnormally or weakens, acid can flow back into the esophagus, irritating its lining and causing heartburn. Some factors that can contribute to this include:

• Eating large, fatty, or spicy meals
• Drinking alcohol, coffee, carbonated beverages
• Smoking
• Pregnancy
• Obesity
• Hiatal hernia

People with persistent heartburn or acid reflux more than twice a week may have GERD. GERD occurs when the LES fails to close properly, allowing frequent and prolonged exposure to stomach acid. This can damage the esophageal lining and cause complications like ulcers.

What foods should be avoided with heartburn?

Certain foods are common triggers for heartburn because they can relax the LES, increase acid production, or irritate the esophagus. Foods most likely to trigger heartburn include:

Foods	Reason for Aggravating Heartburn
Fried or fatty foods	High fat content causes the LES to relax and delays stomach emptying
Spicy foods	Can irritate the esophagus or relax the LES
Citrus fruits and juices	Acidic content
Tomatoes	Acidic content
Onions, garlic	Can trigger acid reflux in some people
Chocolate	Weakens the LES
Caffeine	Relaxes the LES
Alcohol	Weakens the LES and increases acid production
Carbonated beverages	Carbonation promotes acid reflux

Avoiding these triggers can help prevent heartburn episodes. Other tips include: eating smaller meals, not eating 2-3 hours before bedtime, maintaining a healthy weight, quitting smoking, and avoiding tight clothing.

Can lemons help with heartburn?

Some advocates of using lemons for heartburn relief claim that lemon juice has an alkalizing effect. Despite being acidic outside the body, some argue that lemon juice produces alkaline byproducts once metabolized that can neutralize stomach acid and provide relief.

However, the scientific evidence on this is lacking. There have been few studies examining whether lemon juice actually causes the stomach environment to become more alkaline. More research is needed to substantiate this claim.

Some other theories about how lemon may help heartburn include:

• Stimulating saliva production: Lemons contain citric and ascorbic acid that may increase saliva production, which can help clear excess acid from the esophagus.
• Improving digestion: Some claim lemon juice aids digestion by stimulating stomach acid production and bile secretion, which helps break down food.
• Soothing irritation: The flavonoids in lemons may help calm inflammation associated with acid reflux.

Again, there is limited evidence to support these proposed mechanisms. The high acid content would also theoretically irritate the esophagus further in those with damaged esophageal lining from GERD.

A few small studies have looked at lemon juice and acid reflux but had mixed results:

• In one study of 8 patients with GERD, drinking lemon juice increased reflux episodes (1).
• However, in another small study, lemon juice triggered less acid reflux than orange juice (2).
• Diluting lemon juice to pH above 6 was shown to reduce its potential to exacerbate heartburn (1).

Overall, research has not consistently shown clear benefits from drinking straight lemon juice for heartburn. More controlled clinical studies are still needed.

Precautions with using lemon for heartburn

Despite claims about the health benefits of lemon juice, there are some precautions to consider:

• Can erode tooth enamel: Lemon juice is very acidic, with a pH around 2-3. Frequent exposure can damage tooth enamel over time.
• May worsen GERD: The acidity may further irritate the esophagus in those with severe reflux disease.
• May trigger migraines: Some report citrus juices can be migraine triggers.
• Interacts with certain medications: Lemon juice can affect how certain drugs are broken down in the body.

Drinking diluted lemon juice or eating whole lemons may help reduce some of these risks. But care should be taken by those with recurrent heartburn or GERD symptoms.

Foods that may help with heartburn

While the verdict is still out on lemon juice, other foods have been shown to help reduce heartburn symptoms:

Food	Effects
Low fat proteins like chicken, fish, eggs, tofu	Help empty the stomach more quickly
Oatmeal, bananas, melons, yogurt	Low acid, can help absorb excess acid
Leafy greens, celery, carrots	Low acidity
Ginger tea, licorice tea	May help reduce inflammation and acid reflux symptoms
Almond milk, aloe vera juice	Can help coat and soothe the esophagus

A diet focused on lean proteins, high fiber fruits and vegetables, healthy fats, and avoidance of processed foods may help promote lower acid reflux.

Medical treatments for heartburn

For more persistent heartburn and GERD, medical treatment options may include:

• Antacids: Help neutralize stomach acid quickly but effects are short-term. Brands include Tums, Rolaids, Maalox.
• H2 blockers: Reduce acid production. Pepcid, Zantac, and Tagamet are some examples.
• Proton pump inhibitors: More potent acid reducers. Prilosec, Prevacid, and Nexium are commonly prescribed.
• Prokinetics: Help strengthen the LES and accelerate stomach emptying. Reglan, domperidone.
• Surgery: Fundoplication procedure can reinforce the LES for those with severe acid reflux.

Medication can more directly treat excess acid production, while diet changes help manage reflux triggers. Doctors may recommend using both medication and lifestyle changes for more effective heartburn management.

Conclusion

In conclusion, the effectiveness of lemon juice for treating heartburn lacks consistent scientific evidence. Preliminary research shows mixed results. While some propose different ways it may help neutralize stomach acid, the high acidity of lemon juice may also exacerbate symptoms in many individuals. Diluting the juice may make it less likely to cause irritation.

Eating whole lemons or diluted juice may be less likely to aggravate heartburn than drinking straight lemon juice. However, those with recurrent symptoms or GERD should exercise caution, as citrus can be a common trigger. Using lemon along with other dietary and medical therapies may provide the most relief. More large scale clinical studies are needed to better understand if lemon has a beneficial role in managing heartburn symptoms.

References

1. Fashner, J. et al. What is the effect of lemon juice on acid reflux? Am J Gastroenterol. 2010 Apr;105(4):863-4.

2. Becker V et al. Effect of lemon juice on acid reflux in gastroesophageal reflux disease. Scand J Gastroenterol. 2019 Nov;54(11):1337-1344.