The best way to prevent heartburn/GORD is to establish what triggers the problem and to eliminate or avoid the causes where possible.
This can be complicated by the fact that different people can suffer from heartburn for completely separate reasons, though it is usually due to a combination of the below factors.
The following lifestyle changes may be all that’s needed to relieve or prevent your heartburn:
- Lose weight, if necessary. Weight loss is associated with a significant improvement in heartburn and GORD. Exercise several times a week, reduce your portion sizes and eat healthy, balanced meals (include lots of fresh vegetables). Work with a registered dietitian if you struggle to lose weight on your own.
- Eat small, frequent meals and don’t skip meals. Large meals put pressure on your stomach and lower oesophageal sphincter (LES). This could lead to reflux and heartburn.
- Eat slowly and chew your food properly. This will make the food easier to digest and pass through the digestive system.
- Avoid foods and beverages that make your heartburn worse. These differ from person to person, but may include:
- Rich, fatty foods. These foods delay gastric emptying, prolonging the time stomach acid is in contact with the oesophagus.
- Spicy foods, which may irritate the lining of the oesophagus and stomach.
- Alcohol, which may irritate the lining of the oesophagus and stomach.
- Caffeinated, carbonated beverages (e.g. Coca-Cola), which could lead to belching.
- Coffee, which may cause relaxation of the LES.
- Chocolate, which may cause relaxation of the LES.
- Citrus fruits and juices, which are very acidic.
- Tomato sauce, which is also acidic.
- Peppermint and spearmint, which may cause relaxation of the LES.
- Refined starches (e.g. white bread, porridge, pasta), which tend to cause gas.
- Onions, garlic, cucumber and peppers, which tend to cause gas.
- Don’t drink large amounts of fluid with your meals.
- Don’t eat late-night snacks and don’t lie down for 2–3 hours after eating a meal.
- Chew sugarless gum after meals. The saliva generated acts as a buffer to the acid in your digestive system.
- Avoid taking painkillers such as ibuprofen, aspirin and naproxen regularly or in large quantities, as they may irritate the lining of your oesophagus and stomach.
- Sleep on your left-hand side. Research shows that reflux occurs more frequently in people who sleep on their right-hand side.
- Elevate the head of your bed: put the top section of the bed on bricks or blocks, or sleep on a wedge-shaped pillow. Gravity helps to clear the refluxed stomach contents from your oesophagus. Also, reflux experienced during the night tends to be more damaging than reflux experienced during the day.
- Raising your torso might also help, as it reduces pressure on the LES. Use a cushion or a wedge.
- Don’t wear tight-fitting clothes, which can put pressure on your stomach.
- Monitor the effect of certain types of exercise. Bending over, doing heavy lifting, and doing intense physical activity may trigger reflux and heartburn, so it might be better to switch to different or more moderate activities. Note that exercise is extremely beneficial to your overall health, so try to exercise as often as possible. Avoid exercising on a full stomach, and drink a glass of water before and after exercise.
- Quit smoking. The nicotine in cigarettes causes the LES to relax, increasing the risk for reflux and heartburn.
- Keep a diary of what you eat, your activities and the symptoms you experience. This can help you identify which lifestyle factors contribute to your heartburn. There are great phone apps out there to make this process as easy as possible.
- Reviewed by Dr Estelle Wilken, senior specialist in Internal Medicine and Gastroenterology at Tygerberg Hospital, March 2017