When heartburn strikes: what worsens reflux and how to relieve digestion

Šárka Kůrková
2026-04-13T17:11:37+02:00

Heartburn is one of the most common digestive issues. It manifests as an uncomfortable burning sensation in the chest or throat and is usually caused by stomach acid flowing back into the esophagus. If these symptoms occur regularly, it may be gastroesophageal reflux disease (GERD), which according to current estimates affects 10–20% of the Western population. A number of factors contribute to the development of reflux—from diet and lifestyle to the function of the sphincter between the esophagus and the stomach. The good news is that appropriate adjustments to diet, lifestyle, and in some cases targeted supplementation can help relieve symptoms and support digestive health.

What will you learn in this article?

1. What is reflux and why does it occur?

2. Why it’s not just about “excess acidity”

3. Which foods worsen reflux

4. Which foods may help

5. The importance of lifestyle

6. Why medications work but don’t address the root cause

7. Key takeaways

What is reflux and why does it occur?

Reflux occurs when stomach contents flow back into the esophagus. This most often happens due to a weakened lower esophageal sphincter, which under normal conditions prevents stomach acid from flowing backward.

Typical symptoms of reflux include:

heartburn

a sour or bitter taste in the mouth

chest pressure

cough or hoarseness

difficulty swallowing

Several factors contribute to these symptoms, for example:

overeating and large portion sizes

consumption of fatty and sugary foods

overweight or obesity

smoking

alcohol consumption

late dinners or lying down shortly after eating

mineral imbalance

Why it’s not just about “excess acidity”

Heartburn is often automatically associated with the idea that the body produces too much stomach acid. However, this view is oversimplified and in most cases inaccurate. Reflux is not primarily caused by excess acid, but rather by stomach contents moving where they shouldn’t—back into the esophagus.

Key issue: sphincter function, not acid levels

Between the esophagus and the stomach is the lower esophageal sphincter, whose role is to prevent the backflow of food and acid. If this sphincter does not function properly or is weakened, reflux can occur regardless of how much acid the stomach produces. Stress and mechanical pressure on the stomach area, for example due to posture, also play a significant role.

Stress and digestion

During stress, the body switches into “fight or flight” mode, in which digestion is deprioritized. Changes occur in gastrointestinal motility, gastric emptying may slow down, and muscle tension in the abdominal area increases.

Stress can therefore indirectly contribute to reflux by disrupting digestion and affecting the function of the lower esophageal sphincter.

Posture and pressure on the stomach

A highly underestimated factor is also body positioning throughout the day. Prolonged sitting, a hunched back, or a “compressed” abdomen (e.g. when working at a computer) creates mechanical pressure on the stomach, which is literally being compressed. As a result, stomach contents are more likely to flow back into the esophagus. Tight clothing around the waist can have a similar effect. For some individuals, physiotherapy and working on posture and breathing may help alleviate reflux.

Mineral imbalance

The balance of minerals, particularly magnesium and potassium, affects proper muscle function, including that of the lower esophageal sphincter, which prevents the return of stomach contents. A deficiency in these minerals may therefore weaken its function and increase the risk of reflux.

Low stomach acidity

In most cases, reflux is actually influenced by low production of stomach “acid”, known as hypochlorhydria. A lack of HCl may slow digestion and prolong the retention of food in the stomach. Without sufficient antimicrobial action of the acid, undesirable processes such as fermentation can occur, producing gases. These gases increase intragastric pressure, which mechanically weakens the esophageal sphincter and worsens reflux. This condition may also affect protein digestion and the absorption of certain nutrients such as vitamin B12, calcium, zinc, or iron.

From a visual diagnostic perspective, reduced production of hydrochloric acid can be identified by longitudinal ridges on the nails. However, impaired digestion and poor nutrient absorption may also manifest as increased nail brittleness and poor hair quality, which is related to deficiencies in nutrients essential for keratin production, the primary structural protein of nails.

For this reason, in cases of long-term digestive issues, it is important to monitor not only reflux symptoms themselves, but also the overall nutritional status of the body.

Stomach acid production can be supported, for example, by taking a tablespoon of apple cider vinegar with a small amount of water (100 ml), including bitter foods such as arugula or chicory, or herbal bitters (especially dandelion root, gentian, wormwood, chicory, and artichoke), which stimulate digestion before meals.

Which foods worsen reflux

Diet is one of the most significant factors influencing both the development and severity of reflux. Certain foods can relax the lower esophageal sphincter, increase stomach acid production, or slow gastric emptying. All of these mechanisms can increase the likelihood of stomach contents flowing back into the esophagus and contribute to heartburn. Studies show that dietary adjustments are one of the fundamental steps in managing reflux symptoms.

Fatty and fried foods

Foods high in fat slow gastric emptying and increase pressure on the lower esophageal sphincter, which promotes the backflow of stomach contents into the esophagus. These include fried foods, fatty meats, processed meats, or meals prepared with large amounts of fat. Higher fat intake may also contribute to relaxation of the lower esophageal sphincter.

Highly seasoned and irritating foods

Spicy and heavily seasoned foods may irritate the lining of the esophagus and worsen heartburn, especially in more sensitive individuals.

Acidic foods

Citrus fruits, tomatoes, and tomato sauces may increase irritation of the esophagus and thereby worsen reflux symptoms.

Caffeinated beverages

Coffee, energy drinks, or strong tea may relax the esophageal sphincter and stimulate stomach acid production.

Carbonated drinks

The carbon dioxide content increases pressure in the stomach, which may also promote reflux.

Alcohol

Alcohol increases the acidity of stomach contents, relaxes the esophageal sphincter, and may irritate the lining of the esophagus, especially when consumed in larger amounts.

Chocolate and mint

Both foods may promote relaxation of the esophageal sphincter in sensitive individuals and worsen reflux.

Large meal portions

Large portions increase pressure in the stomach and promote reflux, so it is better to eat smaller amounts and avoid overeating, especially in the evening.
However, sensitivity to individual foods varies, so it is important to monitor your own reactions and identify specific triggers.

Which foods may help

Although there is no universal diet, some foods are generally better tolerated and may help relieve reflux symptoms. It is advisable to include foods that generally support the tone of the lower esophageal sphincter. These include protein (especially lower-fat options such as chicken, turkey, or fish) and vegetables in general (especially leafy greens).

We also recommend eating foods rich in fiber, as fiber supports digestion and may reduce the risk of overeating, which is a common reflux trigger. You can therefore add oats, whole grains, legumes, or a greater amount of vegetables to your diet.

Alkalizing and less acidic types of fruits and vegetables may also be a suitable part of the diet in reflux. These foods usually do not irritate the lining of the esophagus and may contribute to better food tolerance in cases of heartburn. Vegetables are generally well tolerated, especially options such as broccoli, asparagus, green beans, or carrots, which are also rich in fiber and other beneficial nutrients.

Among fruits, less acidic types tend to be better tolerated in reflux, such as bananas, apples, or melons. These fruits are less acidic than citrus fruits, for example, and therefore do not worsen symptoms in many people. In addition, they provide vitamins, antioxidants, and fiber that support overall digestive health.

The importance of lifestyle

In addition to diet itself, the way you eat and your lifestyle also play an important role. Overeating, eating in a rush or under stress, and eating right before bed all worsen reflux symptoms. We therefore recommend trying the following:

eat slowly and calmly, chewing each bite thoroughly

eat smaller portions more frequently throughout the day

do not drink during meals or shortly before eating

avoid eating for at least 3 hours before bedtime

remain upright after meals

maintain a healthy body weight

Why medications work but do not address the root cause

Acid-reducing medications (e.g. proton pump inhibitors – PPIs) often provide relief because they reduce the irritant effect of stomach contents. However, they do not address the actual cause of reflux—namely sphincter function, eating habits, or lifestyle. As a result, symptoms often return once they are discontinued. Treatment should therefore include a comprehensive approach focused on dietary and lifestyle changes.

Long-term use of proton pump inhibitors (PPIs) may, on the other hand, lead to reduced stomach acid production, which can subsequently have a negative impact on digestion. Low levels of gastric juices can lead to insufficient protein digestion or impaired absorption of certain nutrients. Reduced stomach acidity also disrupts the body’s natural barrier against microorganisms, which may contribute to bacterial overgrowth in the small intestine (a condition known as SIBO) and the development of intestinal dysbiosis.

Key takeaways

Reflux is not primarily caused by excess hydrochloric acid in the stomach, but by poor function of the lower esophageal sphincter.

Reflux is also influenced by stress, posture, and pressure on the stomach.

Low stomach acid production (hypochlorhydria) may worsen reflux by slowing digestion, increasing intragastric pressure, and weakening the sphincter.

Diet is key—fatty foods, alcohol, and large portions often worsen symptoms.

Including protein, fiber, and more alkalizing fruits and vegetables may help. Lifestyle matters too—smaller portions, meal timing (not eating 3 hours before bed), and stress management all play a role.

Long-term use of medication (PPIs) may relieve symptoms, but it does not address the cause and can negatively affect the absorption of key nutrients (e.g. vitamin B12 and iron).

Stomach acid production may be naturally supported, for example with apple cider vinegar or bitter foods (arugula, chicory) before meals.

Sources:

https://www.lifeextension.com/wellness/lifestyle/nail-ridges

https://easyhealthyfoods.com/what-are-trigger-foods-for-gerd/?utm

https://pmc.ncbi.nlm.nih.gov/articles/PMC4223119/?utm

https://health.clevelandclinic.org/gerd-diet?utm

https://pubmed.ncbi.nlm.nih.gov/22146488/

https://link.springer.com/article/10.1186/s12931-024-02783-5?utm