What juice causes heartburn?
Heartburn is a common problem that many people experience after drinking certain beverages. Heartburn is characterized by a burning sensation in the chest and throat, which occurs when stomach acid backs up into the esophagus. While heartburn can be triggered by a variety of foods and drinks, there are certain types of juice that are more likely to cause heartburn symptoms.
Citrus Juices
Citrus juices like orange, grapefruit, lemon, and lime juice are frequent heartburn culprits. Though citrus fruits contain valuable vitamins and minerals, the high acid content in citrus juice can irritate the esophageal lining and trigger heartburn. Studies show that citrus juices decrease lower esophageal sphincter pressure, making it easier for stomach contents to reflux up into the esophagus.
The high acidity of citrus juice may exacerbate heartburn symptoms in those already prone to acid reflux. Diluting citrus juice with water or mixing it with low acid juices may help reduce acidity. Those with chronic heartburn or gastroesophageal reflux disease (GERD) may need to avoid citrus juice altogether.
Tomato Juice
Tomato juice is another beverage that can provoke heartburn, especially in those with acid reflux. Like citrus juice, tomato juice has a highly acidic pH, ranking around 4.7 on the pH scale. The combination of citric acid, malic acid, and ascorbic acid give tomato juice its tangy, acidic flavor.
Tomato juice’s acidity can irritate the esophageal lining, relaxing the lower esophageal sphincter muscle and allowing stomach acid to reflux into the esophagus. Tomatoes also contain tyramine, a compound that may further stimulate acid secretion and promote heartburn.
Those prone to heartburn should limit consumption of tomato juice or dilute tomato juice with low acid ingredients like almond milk or oat milk. Pureeing fresh tomatoes into homemade juice rather than using store-bought may also reduce acidity.
Cranberry Juice
Tart cranberry juice is a popular beverage rumored to provide numerous health benefits. However, cranberry juice contains organic acids that may stimulate acid production in the stomach, including citric acid, quinic acid, malic acid, and benzoic acid.
The high acid content of cranberry juice lowers pH in the esophagus and stomach, which can impair the function of the lower esophageal sphincter. This relaxation of the sphincter muscle enables reflux of gastric acid into the unprotected esophageal lining, resulting in painful heartburn.
Drinking diluted cranberry juice and avoiding large amounts may help reduce the likelihood of heartburn. Those with frequent heartburn should exercise caution when drinking cranberry juice.
Pineapple Juice
Pineapple juice has a very low pH and high acidity, with citric acid being its primary acid component. The acidity of pineapple juice may promote heartburn in a few ways:
- Irritating the esophageal lining
- Reducing pressure of the lower esophageal sphincter
- Increasing the risk of acid reflux
Pineapple juice and other citrus juices are also common heartburn triggers because they are often consumed on an empty stomach. Drinking any acidic juice on an empty stomach can lead to excessive gastric acid secretion and increase the chance of painful acid reflux.
Apple Juice
Apple juice has a pH ranging from 3.4 to 4, giving it a high acid content. The main acids found in apple juice are malic acid, citric acid, and ascorbic acid. Though the sugar and water content somewhat dilute the acidity, apple juice still sits on the acidic end of the pH scale.
The acidic nature of apple juice may promote heartburn in a few ways:
- Relaxing the lower esophageal sphincter
- Irritating the esophageal mucosa
- Increasing stomach acid production
Apple juice is less acidic than many citrus juices. However, individuals prone to heartburn may still want to limit intake of apple juice or dilute it with water.
Grape Juice
The acids naturally present in grapes give grape juice an acidic pH ranging from 2.9 – 4.5. Grape juice contains high amounts of tartaric acid and malic acid, both of which have been shown to increase heartburn.
One study found that drinking 200mL of grape juice significantly decreased lower esophageal sphincter pressure in both healthy individuals and heartburn patients. The drop in pressure caused by grape juice enabled acid reflux in many subjects.
Those prone to acid reflux issues should limit intake of grape juice, especially in large quantities. Diluting grape juice with low acid liquids may help minimize heartburn symptoms.
Factors That Contribute to Juice Causing Heartburn
Besides the innate acidity, there are other factors that can make drinking juice more likely to cause heartburn symptoms:
- Drinking juice on an empty stomach – Without food, juice can more readily irritate the esophageal lining.
- Drinking large amounts – More juice means more acid exposure.
- Habitual consumption – Frequent juice drinking increases risk of heartburn.
- Individual sensitivity – Those already prone to reflux are more sensitive.
- Citrus juice with pulp – Citrus pulp may aggravate the esophagus.
- Carbonated juice – Bubbles may increase pressure on the esophageal sphincter.
Tips to Prevent Juice-Related Heartburn
Certain steps can be taken to enjoy juice without provoking heartburn symptoms:
- Drink juice with a meal
- Avoid drinking large amounts of juice, especially in one sitting
- Dilute juice with water or non-acidic liquids like almond milk or oat milk
- Avoid drinking juice on an empty stomach
- Drink low-acid juices like grapefruit, pear, or aloe vera juice
- Avoid carbonated juices
- Use a straw when drinking juice to minimize contact with the esophagus
Most Acidic Juices to Avoid with Heartburn
| Juice Type | pH |
|---|---|
| Lemon juice | 2.0-2.6 |
| Lime juice | 2.0-2.5 |
| Grapefruit juice | 2.9-3.3 |
| Orange juice | 3.3-4.2 |
| Cranberry juice | 2.3-2.7 |
| Pineapple juice | 3.2-4.0 |
Juices with a lower pH contain more acids that can trigger heartburn symptoms. The most acidic juices listed above are more likely to cause problems for those prone to acid reflux or GERD.
Summary
Many types of juice have the potential to cause heartburn due to their high acid content. Citrus juices, tomato juice, cranberry juice, pineapple juice, apple juice, and grape juice are most frequently associated with heartburn symptoms. Factors like drinking juice on an empty stomach, chugging large amounts, and inherent sensitivity can increase the likelihood of juice triggering acid reflux.
Diluting juice, avoiding juice on an empty stomach, limiting serving sizes, and choosing low acid juices may help prevent heartburn. Those with chronic reflux issues may need to avoid acidic juices altogether to find relief.
