What Causes Heartburn? 6 Root Causes You Might Be Overlooking
🕒 9-10 min read
In a hurry? These are the highlights worth knowing:
Heartburn isn't always about too much acid - root causes like low stomach acid, stress, or gut imbalances are often the real culprits.
Start tracking your meals and symptoms to uncover what’s actually triggering the burn.
Download your free 7-Day Food & Observation Journal to get curious and take control of your symptoms.
If you’re tired of the Tums cycle and want lasting relief that actually makes sense, this post is here to support your next step.
📌 Keep reading - or save this post for later when you're ready to find real relief from the burn.
If you’ve ever felt like you swallowed a ball of fire after a meal, you’re not alone. Heartburn affects millions of people every day. While it might seem like a minor nuisance that just needs a quick Tums, it’s often a signal that something deeper is going on in your digestive system.
In my 12+ years as a nutrition professional, I’ve worked with countless clients who’ve battled this fiery beast - some for decades - believing their only option was a prescription or daily acid blocker. But I’m here to tell you: once you understand the root cause of your symptoms, there is often a more holistic, effective path to relief - without relying on the pharmacy aisle.
Let’s explore what heartburn actually is, why it happens, and what you can do about it starting today.
What Is Heartburn?
Despite the name, heartburn has nothing to do with your heart. That burning feeling actually starts in your esophagus - the tube that carries food from your mouth to your stomach. Just before food enters your stomach, it passes through your lower esophageal sphincter (LES) - a muscular gateway that opens only when food is ready to pass through.
When your LES is healthy and strong, it stays closed the rest of the time, keeping stomach acid where it belongs. But when this gateway weakens or relaxes at the wrong time, acid can creep back up into your esophagus - which isn’t designed to handle that kind of acidity. Hello, fireball.
Why Does Heartburn Happen?
6 Common Root Causes
Understanding why you’re experiencing heartburn is key to finding long-term relief. Here are the most common culprits:
When your lower esophageal sphincter (LES) doesn’t stay tightly closed, stomach acid can travel upward into the esophagus, causing the uncomfortable burning sensation known as heartburn.
1. A Weak LES
A weakened or dysfunctional lower esophageal sphincter can allow stomach acid to escape into your esophagus.
What weakens your LES?
Aging
Obesity
Smoking
Certain medications (like some antidepressants, blood pressure meds, and even long term use of acid blockers)
Stress and anxiety
Low stomach acid levels
💡 TIP: Support your LES by maintaining a healthy weight, managing stress, quitting smoking and supporting healthy stomach acid levels.
2. Low Stomach Acid (Hypochlorhydria)
It might sound counterintuitive, but low stomach acid is often to blame for heartburn. This can be a tricky concept to grasp - especially when you’re feeling the burn and assuming it’s from too much acid. But here’s the twist: without enough stomach acid, your lower esophageal sphincter (LES) may not stay tightly closed. That means even a small amount of acid can escape into your esophagus and cause that uncomfortable burning.
Signs of low stomach acid include:
Bloating or fullness after meals
Burping or excess gas
Nutrient deficiencies (B12, iron, magnesium, calcium)
Brittle nails and thinning hair
💡 TIP: Try apple cider vinegar or digestive bitters before meals to gently increase stomach acid.
3. Dietary & Lifestyle Triggers
Certain habits and foods can also trigger heartburn, especially if your LES is already weakened.
Common triggers include:
Eating too fast or overeating
Lying down too soon after meals (especially with a weak LES)
Processed foods, sugar, and refined carbs
Alcohol and caffeine
Spicy, fatty, or acidic foods
💡 TIP: Slow down while eating, and focus on whole, nutrient-dense meals to help reduce symptoms.
Sugary treats and caffeine-packed drinks like coffee are two common culprits when it comes to heartburn.
Tired of guessing what’s causing the burn? Check out my blog, Journaling for Digestive Health, and learn how to connect the dots between your habits and your symptoms - so you can feel better, faster.
4. Low Digestive Enzymes
Digestive enzymes help break down your food. When enzyme levels are low, food sits for longer and can ferment in your gut, causing gas and pressure that can push acid upward.
💡 TIP: A high-quality digestive enzyme supplement may ease bloating and reduce reflux symptoms.
5. Bacterial and Fungal Imbalances
Gut microbiota imbalances can interfere with digestion and contribute to heartburn.
H. pylori can alter stomach acid levels, sometimes lowering them significantly.
SIBO (small intestinal bacterial overgrowth) produces gas that increases pressure on your LES.
Candida overgrowth can inflame the digestive tract and worsen symptoms.
💡 TIP: Balance your microbiota through diet, lifestyle, and targeted supplements.
6. Hiatal Hernia
When a part of your stomach pushes through your diaphragm, it can make acid reflux more likely. This condition often goes unnoticed but can be a key contributor.
Struggling to pinpoint what’s triggering your heartburn?
Download your FREE 7-Day Food & Observation Journal today and start uncovering the messages your gut has been sending you.
Tracking your meals and symptoms is a powerful first step in identifying your unique heartburn triggers.
How to Find Relief from Heartburn
A Gentle, Root-Cause Approach
Here are a few steps you can take right now to begin healing:
Track your symptoms. Start by noticing which foods or habits are linked to your heartburn.
Support digestion naturally. Try digestive bitters or apple cider vinegar before meals.
Slow down while eating. Chew thoroughly, take deep breaths before meals, and avoid distractions.
Avoid common triggers. Caffeine, high sugar diet, excessive processed carbohydrates, alcohol, spicy or fatty foods, and large meals are common culprits.
Balance your gut. Consider probiotics, fermented foods, and a gut-supportive lifestyle.
Check for underlying imbalances. Work with a practitioner to explore SIBO, H. pylori, Candida overgrowth, or low stomach acid.
When to See a Doctor
Lifestyle changes can help in many cases, but you should consult your healthcare provider if you experience:
Heartburn more than twice a week
Trouble swallowing
Chronic cough or hoarseness
Regurgitation of food
Chest pain
Persistent heartburn can sometimes signal more serious conditions like Barrett’s Esophagus, so it’s important to rule those out.
Final Thoughts: There’s Hope for Heartburn Relief
Heartburn isn’t just about spicy food or big meals - it’s often a message from your body that your digestion needs support. By addressing the root causes, from stress to stomach acid levels to bacterial balance, you can feel real relief.
Even small changes, like chewing more slowly or adding digestive bitters, can make a big difference. With the right approach, you can reduce your reliance on acid blockers, enjoy your meals without worry, and finally find freedom from the fiery beast.
FAQs About Heartburn Relief
What foods trigger heartburn the most?
Spicy foods, fried or fatty meals, citrus, tomatoes, chocolate, coffee, alcohol, and carbonated drinks are the most common. But overeating at meals or a chronically low protein intake can also trigger heartburn.
Is heartburn a sign of too much or too little stomach acid?
It’s often a sign of too little stomach acid, especially if you feel bloated or gassy after eating.
Can stress cause heartburn?
Absolutely. Stress can weaken your LES and interfere with digestion. Breathing exercises, movement, and mindfulness can help.
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RESOURCES
American College of Gastroenterology. Acid Reflux / GERD Overview. https://gi.org/topics/acid-reflux/. Accessed April 1, 2025.
Antunes C, Aleem A, Curtis SA. Gastroesophageal Reflux Disease. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jul 3. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441938/
Beveridge CA, Hermanns C, Thanawala S, et al. Predictors of persistent symptoms in eosinophilic esophagitis after remission: fibrostenosis, eosinophilia, anxiety, and depression. Dis Esophagus. 2025;38(1):doae110. doi:10.1093/dote/doae110
Fatima R, Aziz M. Achlorhydria. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Aug 14. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507793/.