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7 Causes of Heartburn That Aren’t Food-Related

July 16, 2024

Even if you skipped the loaded nachos, heartburn can still strike. It’s not just food that can set your insides on fire.

“Non-food related factors can significantly contribute to heartburn symptoms,” says Rohit Singhania, MD, a gastroenterologist and hepatologist with Hartford HealthCare. “Awareness of these causes is key to better managing and preventing heartburn.”

Here are a few causes of heartburn that aren’t food-related.

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1. Lifestyle habits

Your lifestyle and overall health can have an impact on your digestive system

Smoking, for instance, relaxes the gastroesophageal junction (GEJ), making it easier for stomach contents to flow back into the esophagus.

And for those who are obese, you may have extra pressure on your abdomen. In turn, this pushes acid, bile, air and food into the esophagus, which leads to symptoms.

> Related: 4 Home Remedies for Heartburn That Actually Work

2. Hiatal hernia

Hiatal hernias — which happen when the upper part of your stomach pushes up into your chest — can also cause heartburn symptoms.

This happens because when the stomach slides into the chest, the valve between the stomach and esophagus (GEJ) can weaken, leading to reflux.

3. Stress

Take a deep breath if you’re feeling frazzled.

Stress can increase the sensitivity of esophageal pain receptors and lead to heartburn.

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4. Pregnancy and hormonal changes

If you weren’t anticipating heartburn with changing hormones, here’s why there’s a connection.

For starters, the increased pressure from the fetus on the stomach can cause reflux.

Hormonal changes during pregnancy, like higher levels of progesterone, can relax the lower esophageal sphincter (LES), making it easier for stomach contents to flow back into the esophagus.

5. Medications

Your medicine cabinet can be a surprising heartburn culprit. This happens for one of two reasons:

  • Inflammation of the esophagus: Antibiotics, bisphosphonates, iron pills, pain medications (like Motrin), over-the-counter medications, potassium supplements and quinidine can all cause reflux.
  • Relaxation of the LES Muscle: Asthma medications, sedatives, blood pressure medications, pain medications (like narcotics), hormones (like progesterone) and some antidepressants can also contribute to heartburn.

6. Motility disorders

If you have a motility disorder, food and waste move through the digestive tract abnormally, causing issues with clearing acid or food from the esophagus.

7. Connective tissue disorder

Conditions like scleroderma can impact how the esophagus works and moves, making it hard to clear contents from the esophagus.

If your heartburn sticks around, get checked out.

“If you have persistent heartburn, please see your doctor,” advises Dr. Singhania.

You should also talk to your provider if you experience any of the following:

  • Severe symptoms that affect your daily life, like sleep and work.
  • Symptoms without a clear cause.
  • Frequent symptoms (more than once a week).
  • Heartburn that doesn’t respond to over-the-counter treatments.
  • Symptoms like weight loss, difficulty swallowing, persistent nausea or vomiting.

“Your physician can help you with an individualized treatment plan,” says Dr. Singhania. “We can work together to prevent complications, prescribe medication and effectively manage your heartburn to help you enjoy life more fully.”