1. Heartburn: Foods to Eat, Foods to Avoid Slideshow Pictures
2. Digestive Disease Myths Slideshow Pictures
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Medical Author:

John P. Cunha, DO, FACOEP

John P. Cunha, DO, FACOEP

John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.

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Medical Editor:

Bhupinder Anand, MD

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 end 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 the stomach is protected from its own acid by a special mucous layer. The esophagus does not have this special protection. If the lower esophageal sphincter does not close completely, the lower part of the esophagus can be damaged by refluxing stomach acid. When this occurs, heartburn may be experienced.

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

• Certain foods and drinks the lower esophageal sphincter. These include chocolate, peppermint, caffeinated 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 a person is lying on the back, on the right side, or bending over.
• Anything that increases the pressure in the abdomen, forcing stomach acid backward into the esophagus, can cause heartburn. Lifting, straining, coughing, tight clothing, obesity, and pregnancy can worsen heartburn.
• People with certain medical conditions have an increased risk of heartburn. These conditions include: hiatal hernia, diabetes, gastroparesis, and many autoimmune diseases (CREST syndrome, Raynaud's phenomenon, and scleroderma).
• Many prescription medications can loosen the lower esophageal sphincter, including blood pressure and heart medications, and the asthma drug theophylline.
• Many substances directly irritate the lining of the esophagus and contribute to heartburn. These include spicy foods, citrus fruits and juices, tomatoes and tomato sauces, cigarette smoke, aspirin, ibuprofen (Motrin, Advil etc.), and medicine prescribed to treat osteoporosis.

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