What should I drink when I have heartburn?
Heartburn is a painful burning sensation in the chest or throat that occurs when stomach acid backs up into the esophagus. It is estimated that over 60 million Americans experience heartburn at least once a month. While heartburn is often caused by eating certain trigger foods, the beverages you drink can also play a role in causing or relieving heartburn symptoms.
Causes of Heartburn
Heartburn occurs when stomach acid flows back up into the esophagus, the tube that carries food from the mouth to the stomach. Normally, a ring-like muscle at the bottom of the esophagus called the lower esophageal sphincter (LES) prevents backflow of stomach contents. However, if the LES relaxes inappropriately or is weakened, acidic stomach contents can reflux into the esophagus, causing a burning pain known as heartburn.
Some common causes and triggers of heartburn include:
- Eating large, heavy meals
- Eating fatty, greasy, or spicy foods
- Drinking certain beverages like alcohol, coffee, or soda
- Eating too close to bedtime
- Smoking cigarettes
- Pregnancy
- Obesity
- Hiatal hernia
- Stomach ulcers
- Certain medications like NSAIDs or blood pressure medications
Beverages to Avoid with Heartburn
Certain beverages are common heartburn triggers and may worsen symptoms. Beverages to avoid include:
Alcohol
Alcohol can directly irritate the esophagus and relax the lower esophageal sphincter, allowing stomach acid to reflux. Red wine, in particular, contains high amounts of tannins which can increase stomach acid production. It’s best to avoid or limit alcohol if you experience frequent heartburn.
Carbonated Drinks
The bubbles in carbonated drinks like soda and sparkling water can cause belching, which promotes reflux of stomach acid. The acidity of sodas can also trigger heartburn symptoms. Limit or avoid drinking carbonated beverages.
Coffee and Tea
Caffeinated drinks like coffee, tea, and energy drinks can relax the LES muscle and stimulate acid production in the stomach. This can lead to acid reflux. Limit caffeine intake to less than 200-300 mg per day.
Citrus Juices
The high acid content in citrus juices like orange, grapefruit, or lemon can irritate the esophagus lining and worsen heartburn. Avoid drinking large amounts of citrus juice, especially if you have frequent heartburn.
Iced Tea
While hot tea can sometimes help soothe heartburn symptoms, iced tea is generally considered a trigger food. The combination of caffeine plus the acidity of the tea can promote reflux. Switch to herbal, decaffeinated iced tea.
Beverages that May Help Alleviate Heartburn
While certain drinks can trigger heartburn, other beverages may help improve symptoms. Some options to consider include:
Low-Acid Fruit Juices
Fruit juices like apple, pear, pineapple, or aloe vera juice contain less acid and can help neutralize stomach acid when heartburn strikes. Avoid citrus juices high in acid.
Herbal Tea
Warm, caffeine-free herbal teas like chamomile, peppermint, licorice, or ginger can help reduce inflammation and calm an upset stomach. Steep the tea bag for at least 5 minutes to maximize benefits.
Low-Fat Milk
Calcium-rich milk can temporarily help neutralize stomach acid. However, only drink 1 cup at a time to avoid increasing stomach acid production.
Almond Milk
The alkaline nature of almond milk can help neutralize stomach acid. Choose unsweetened varieties to avoid added sugars. Do not drink almond milk if you have a nut allergy.
Aloe Vera Juice
Pure aloe vera juice has anti-inflammatory properties that can help heal the esophagus lining and reduce irritation. Drink 1⁄4-1⁄2 cup 20 minutes before meals.
Baking Soda Water
A mixture of 1⁄2 teaspoon baking soda in 4-8 ounces of water can temporarily neutralize stomach acid and provide relief. Do not drink regularly as it contains high sodium.
Fennel Tea
Fennel seeds contain compounds that relax the LES muscle and stimulate mucus production, protecting the esophagus. Steep 1-2 teaspoons of fennel seeds in hot water for 5-10 minutes.
Marshmallow Root Tea
Marshmallow root contains mucilage which coats and protects the esophagus. Make tea by steeping 2 teaspoons of the dried root in 1 cup hot water for 5-10 minutes.
Tips for Preventing Heartburn
Making certain lifestyle changes can help prevent heartburn symptoms from occurring in the first place:
- Eat smaller, more frequent meals
- Avoid eating 2-3 hours before bedtime
- Quit smoking and limit alcohol intake
- Maintain a healthy weight
- Wear loose fitting clothing
- Raise the head of your bed 6 inches
- Avoid trigger foods and beverages
When to See a Doctor
While occasional heartburn is common and usually manageable with lifestyle changes and over-the-counter medication, frequent or severe symptoms may require medical attention. See your doctor if you experience:
- Heartburn more than 2 times per week
- Symptoms that disrupt sleep or impact quality of life
- Difficulty swallowing
- Unexplained weight loss
- Vomiting or nausea
- Heartburn accompanied by lightheadedness, sweating, or chest pain
Persistent heartburn symptoms may be a sign of gastroesophageal reflux disease (GERD) and can sometimes develop into a more serious condition like esophageal cancer if left untreated. Your doctor can help diagnose the cause and recommend appropriate treatment options.
Treatment Options for Heartburn
If lifestyle and diet changes are not enough to control heartburn flares, several over-the-counter and prescription treatment options are available:
| Treatment | How It Works |
|---|---|
| Antacids (Tums, Rolaids, etc) | Neutralize stomach acid to relieve heartburn |
| H2 blockers (Zantac, Pepcid, etc) | Reduce acid production for longer relief |
| Proton pump inhibitors (Prilosec, Nexium, etc) | Block acid pumps in the stomach |
| Prokinetics (Reglan, etc) | Help empty the stomach more quickly |
| Surgery (fundoplication, etc) | Repair or reinforce the LES |
Talk to your doctor to determine which options may be most appropriate to manage your heartburn symptoms long-term.
Conclusion
Certain beverages like alcohol, carbonated drinks, coffee, and citrus juice can trigger or worsen heartburn symptoms. However, there are also some beverages that may help improve heartburn, including herbal teas, aloe vera juice, almond milk, and marshmallow root tea. Paying attention to dietary triggers, making lifestyle changes, and talking to your doctor can help prevent and manage heartburn flare ups.