Heartburn Causes

The food that is swallowed travels from the mouth to the stomach through a hollow tube called the esophagus (or food pipe). Before entering the stomach, food must pass through a tight muscle at the lower part of the esophagus called the lower esophageal sphincter (LES). The lower esophageal sphincter prevents food from traveling backward into the esophagus.

Once in the stomach, stomach acid digests the food. This acid is very strong and can damage most parts of the body. Fortunately, the stomach is protected from its own acid by a special mucous layer. The esophagus, however, does not have any such special protection. If the lower esophageal sphincter does not close completely, the lower part of the esophagus can be damaged by stomach acid. When this happens, heartburn may be experienced.

The lower esophageal sphincter may not close completely thus allowing stomach acid into the esophagus for these reasons:

• Certain foods and drinks are known to loosen the lower esophageal sphincter. These include chocolate, peppermint, caffeine-containing beverages (such as coffee, tea, and soft drinks), fatty foods, and alcohol.

• Heartburn often depends on the body's position. It is easier for stomach acid to flow back into the esophagus if you are lying down or bending over.

• Anything that increases the pressure on the stomach and forces stomach acid backward into the esophagus can also cause heartburn. This is why lifting, straining, coughing, tight clothing, obesity, and pregnancy can worsen heartburn.

• People who suffer from certain medical conditions may have an increased chance of heartburn. These conditions include hiatal hernia, diabetes, and many autoimmune diseases (CREST syndrome, Raynaud phenomenon, and scleroderma).

• Many prescription medications can loosen the lower esophageal sphincter, including certain blood pressure and heart medications, and the asthma drug theophylline.

• Many substances directly irritate the lining of the esophagus and can contribute to heartburn. These include spicy foods, citrus fruits and juices, tomatoes and tomato sauces, cigarette smoke, aspirin, ibuprofen (with brand names such as Motrin and Advil), and medicines for osteoporosis.