Man suffering from heartburn after eating an orange.

Heartburn - what helps when acid hits the wrong place?

Great numbers of the world’s population regularly suffer from heartburn. The affected are severely limited by the symptoms sleep, decreased appetite and a drop in quality of life. What many do not know: Often, it is not too much acid that is to blame for the discomfort. But what is the most common cause? And what helps against heartburn?

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How heartburn develops

Anyone who has to fight heartburn might also complain about a feeling of fullness, stomach ache and acid regurgitation, and especially about a burning pain or rather a pressing feeling behind the breastbone. Burping and swallowing difficulties might also present themselves. Depending on the severity, heartburn may be mild or very painful, even radiating to the throat. As a result of the reflux of gastric contents, an acidic taste sometimes spreads in the mouth, which can also be described as salty or soapy. This can lead to bad breath. Heartburn can also be associated with nausea and vomiting. The symptoms may also manifest outside the digestive tract. Furthermore, heartburn can be associated with irritable cough, hoarseness and asthma.

Among other factors, gastric juice plays an important role in heartburn. It consists, among others, of hydrochloric acid and some digestive enzymes. After food is broken down by the teeth, the gastric juice begins to digest the food further and kill off germs or pathogens. Heartburn, the well-known "burning fire" in the oesophagus, occurs when gastric acid gets back into the gullet and irritates the mucous membranes. So, the main cause of heartburn is not necessarily too much acid, but acid in the wrong place or hypersensitive oesophageal nerves. The latter may also explain why reflux leads to unpleasant symptoms in some people while others don't even notice gastric juice flowing back into the gullet.

In general, reflux episodes are not unusual and can occur to anyone from time to time. This "normal" reflux, also called physiological reflux occurs to everybody every day and is usually harmless. In contrast, there is the “pathological” reflux, which has organic causes and can even damage organs.

Responsible for too many reflux episodes or too much gastric juice reflowing into the oesophagus, is, in most cases, the oesophageal sphincter, the closure between the oesophagus and the stomach. Normally, the sphincter muscle works like a valve and prevents uncontrolled backflow of gastric contents into the oesophagus. As a result, the digestion proceeds undisturbed, without excessively affecting the preceding, sensitive oesophagus. However, if the muscle does not close properly or opens too often during the digestive process, gastric acid and chyme can return too often, in greater quantity or too far back into the oesophagus. Heartburn and acid regurgitation are the consequence.

In particular, when other gastrointestinal complaints join, it could be possible that the movement processes or sensitivity of nerves in the gastrointestinal tract are disturbed. This is often what happens if you suffer from a functional disorder like IBS or irritable stomach.

Accompanying symptoms of heartburn may include:

  • Nausea
  • Abdominal pain
  • Flatulence
  • Stomach pain
  • Feeling of fullness
  • Stomach pressure

What are the reasons for heartburn?

Lifestyle can affect heartburn

Patients with irritable stomach often suffer from heartburn, which can, for example, be additionally triggered by stress or improper diet. The triggers set very different mechanisms in motion - often even several at the same time - that ultimately cause the symptoms. For example, unhealthy and high-fat foods can increase gastric acid output, while emotional stress or obesity could lead to stomach pressure. Smoking, alcohol and coffee have also been shown to promote heartburn. These factors are among the most common triggers of heartburn. The good news is that you can do a lot to turn the tide. It is not always easy to change your habits, but it's worth a try, since it may help you feel better soon. What is first perceived as a restriction, could quickly turn out to be a gain.

Here is a list of foods and beverages that can promote heartburn:

  • Coffee and black tea
  • Carbonated beverages
  • Alcohol (red wine and white wine)
  • Strongly flavoured food
  • Apple
  • Sweets (chocolate)
  • Citrus fruits
  • Nuts (except almonds!)
  • Fried foods (chips, crisps)
  • Pulses (beans, peas)
  • Mayonnaise
  • Onions

Disturbed motility

In patients with irritable stomach or irritable bowel syndrome, heartburn can be caused by a motility disturbance in the gastrointestinal tract. In general, disturbed motility of the stomach may result in an insufficient basal tension in the lower part of the stomach. This may lead to food not being delivered to the small intestine in a healthy rhythm. To further complicate the work of the stomach, the gastric reservoir may not stretch far enough for food intake. In this case, it is possible that too much pressure builds up towards the oesophagus. At some point, the sphincter cannot withstand this pressure build-up and gastric acid may flow back into the oesophagus. There it can irritate the sensitive mucous membrane and cause heartburn.

Hypersensitive nerves

The oesophagus automatically transports food and fluids into the stomach after swallowing. We only become aware of this process when the food or drink is overly hot or cold or when we have taken too much of a bite. This is due to the oesophageal nerves within the mucosa. In some people, these nerves are extremely sensitive and react more strongly than usual to stomach acid, for example. This can result in heartburn. Furthermore, it was shown that repeated irritation of the mucous membrane of the oesophagus by aggressive gastric acid can lead to a sensitization of the pain receptors located there. Consequently, these receptors become somewhat more sensitive to pain after each reflux episode so that pain intensity can gradually increase over months or years.

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Chronic increase in pressure

A chronic increase in pressure in the abdominal cavity can lead to chronic heartburn. The increased pressure stresses the sphincter, which reduces the tension condition. An increase in pressure occurs during pregnancy, for example. An increased body weight might lead to a reduced tension, which manifests itself in chronic heartburn.

Diaphragmatic hernia

Diaphragmatic hernia or severe weakness of the diaphragm can also lead to chronic heartburn. Chronic heartburn is a common symptom, especially in larger fractures.


This disease is rather rare; Scleroderma patients are mostly affected at the junction between the esophagus and the stomach, where the connecting tissue hardens. This leads to a disruption of the connective tissue and the functioning of the sphincter is impaired, and patients can develop chronic heartburn.

How long does heartburn last?

If heartburn persists for an extended period of time, it is called chronic heartburn. If you experience the typical symptoms for more than one month, the cause should be clarified with your physician and, if necessary, appropriate therapy initiated. They can determine whether the sphincter muscle between the oesophagus and stomach no longer functions properly, whether it is a symptom of functional gastrointestinal disorder (FGID) like irritable stomach or irritable bowel syndrome or something completely different.

In addition, individual factors also affect the sensation and duration of heartburn. Patients with a sensitive oesophagus suffer longer than patients with a comparatively insensitive oesophagus. Age probably also affects the outcome. Older people seem to suffer less than younger patients, even if they experience a similar or greater amount of reflux. Stress and psychological aspects can also influence the intensity or duration of the symptoms.

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Heartburn and heart attacks

Heartburn can cause symptoms similar to those of a heart attack. And although heartburn causes no acute health risks, a heart attack is life-threatening. Please call for emergency services if you have any doubts about the symptoms you experience. Please do not try a self-diagnosis - only an expert with enough knowledge on the symptoms and their interpretation can give you a correct diagnosis.

In case of the following symptoms or if you feel insecure, call an ambulance:

In a heart attack, different localizations of the pain are possible. It most commonly occurs in the left thorax, which can radiate into the left arm, but a heart attack can also feel like abdominal or back pain. The pain of a heart attack is often much stronger and stabbing than in heartburn. Concomitant symptoms such as shortness of breath, weakness and cold sweats often occur during a heart attack. Women might experience light-headedness or abdominal pain.

Both diseases also differ at the beginning of the symptoms. Heartburn usually occurs after a full meal or after lying down. Typical triggers of a heart attack might be heightened effort or stress states. Younger people rarely suffer from a heart attack. In this case, heartburn is the most common cause of chest trouble. In older people who have never suffered from heartburn and are now complaining about new symptoms, a heart attack is much more likely. As mentioned earlier – if you have any doubts, don’t hesitate to consult a medical professional as soon as possible.

Heartburn in the 3rd trimester of pregnancy

Heartburn is especially common during pregnancy. There are several reasons for this: During pregnancy, there is an increase in female sex hormones and strong changes in a pregnant person's body. In particular, the corpus luteum hormone leads to a general weakening of the muscles of the digestive tract. In addition, the uterus becomes larger due to the steady growth of the child. The lack of space in the abdominal cavity leads to increasing pressure. This also affects the stomach and leads to increased heartburn. You can relieve it, for example, by not eating foods that promote heartburn. Read more on this in the chapter "What are the reasons for heartburn?". Should you have any doubts during your pregnancy or if you wish to take medication, please, make sure to always see your physician.

Natural remedies for heartburn

Fortunately, the unpleasant symptoms of heartburn can very often be targeted with natural remedies. The following tips could help you.

Which drinks are effective against heartburn?

Drink a glass of still water very slowly, sip by sip as it may dilute gastric acid. In mild heartburn, drinking tea might also be very helpful, especially herbal teas from medicinal plants such as chamomile, fennel, yarrow, anise, lemon balm, cumin or ribwort. Some people report that milk helps them. On the other hand, it is said that milk, especially in high quantities, tends to promote heartburn. As with any advice, it is best to find out for yourself what actually helps you.

Which foods are effective against heartburn?

Bananas are discussed to protect the stomach lining. Up to three bananas a day should be fine. Some patients report that a raw carrot or a boiled potato can also help. A few almonds, nuts, a piece of white bread or oatmeal can relieve heartburn in some cases, too. In addition, healing clay is a well-known home remedy to relieve such discomfort. A perfect remedy, if a bit unusual is chewing gum, as it stimulates saliva production which may dilute gastric juice.

Heartburn - what helps?

In most cases, those affected are forced to ask one question: what helps against my heartburn? The treatment is often difficult. The triggers cannot always be avoided - because they are often difficult to influence from the outside. Every person is different, but some remedies have already proven their worth for many.

In general, physiological reflux or occasional heartburn is harmless, but may be bothersome and thus relief of this symptom is suggested for achieving a better quality of life.

In cases of frequent or even regular heartburn, medical treatment is inevitable. Because heartburn can lead to long-term consequences like damage and inflammation of the oesophagus mucosa. These conditions can be traced back to the continuous reflux of gastric juice. Working together with your healthcare professional can help decide on the most appropriate treatment of your heartburn.

While most heartburn drugs bind gastric acid or reduce its production, Iberogast® takes a different approach. The natural herbal drops not only effectively relieve discomfort in the gastrointestinal area, they also target several factors that can cause heartburn in conjunction with other gastrointestinal complaints, like relaxing muscles in the upper part of the stomach.

The unique combination of nine proven herbal extracts is able to target various symptoms of functional disorders and can thus offer fast relief to heartburn in the frame of functional dyspepsia. Iberogast® has been shown to relax the stomach muscles, reduce the production of gastric acid and calm hypersensitive gastric nerves.

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Disturbances in the gastrointestinal tract are usually not only extremely unpleasant and associated with numerous complaints, they often make a normal everyday life even harder. It’s good that there is Iberogast®: The combination of nine medicinal plants targets both the underlying causes and the annoying symptoms.

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