Why Acid Reflux Burns (and 3 Fixes That Actually Help)

That burning feeling behind your breastbone has a simple cause: stomach acid ended up somewhere it was never meant to be.

Your stomach is built for acid. Your esophagus isn't.

Your stomach makes strong acid all day to break down food, and its lining is built to handle it. The esophagus, the tube that carries food down from your throat, has no such protection.

Between the two sits a ring of muscle called the lower esophageal sphincter, or LES. Think of it as a one-way valve. It opens to let food into your stomach, then closes to keep acid in.

When that valve relaxes at the wrong time, or doesn't close tightly, acid splashes up into the esophagus. That's reflux. The burn you feel is acid irritating tissue that can't defend itself.

What makes the valve leak

A few things make it more likely:

• A very full stomach. Stretching the stomach makes the valve relax more often.
• Lying down soon after eating. Gravity stops helping keep acid down.
• Pressure on your belly. Tight waistbands, bending over, or extra weight around the middle push up on the stomach.
• Your personal triggers. Coffee, alcohol, chocolate, fatty or spicy food and tomato bother a lot of people, but not everyone. Triggers are personal, so test yours instead of cutting everything.

Fix 1: Sleep on your left side

On your left side, your stomach sits below your esophagus, so acid has to travel uphill to reach it. Studies measuring acid at night found less acid exposure lying on the left than on the right or on your back.

If night is your worst time, also raise the head of your bed 6 to 8 inches with risers or a foam wedge. Stacked pillows don't work as well because they bend you at the waist. There's more on this in our nighttime reflux tips.

Fix 2: Eat a reflux-friendly day

Lower-fat, lower-acid meals are easier on the valve. A simple day might look like:

• Breakfast: oatmeal with sliced banana and a little honey
• Lunch: grilled chicken, white rice and steamed broccoli. Make this your biggest meal.
• Dinner: baked salmon, roasted potatoes and green beans, on a smaller plate, finished 3 hours before bed

Our GERD diet guide goes deeper on what to eat.

Fix 3: Find your own triggers

The common trigger lists are a starting point, not a rulebook. Many people cut out coffee, tomato and chocolate and still burn, because their real trigger is something else, or it's portion size and timing more than any one food.

Keep a simple log of what you eat and when the burn shows up. After a couple of weeks, patterns get obvious. GERDBuddy can scan a meal before you eat to show a reflux score and the likely triggers, and it keeps the log for you.

When the burn needs a doctor

Occasional heartburn is common. See a doctor if you have heartburn more than twice a week, trouble or pain swallowing, vomiting, black stools, or weight loss you can't explain. And if you have chest pain, especially pain that spreads to your arm or jaw, with shortness of breath or sweating, call 911. You can't reliably tell heart pain from reflux pain on your own. Read more on chest pain and reflux.