What Causes Heartburn? 6 Root Causes You Might Be Overlooking

🕒 9-10 min read

Woman holding a piece of chocolate, looking up in contemplation about how food affects her digestion.

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:

Diagram showing how acid reflux occurs when the lower esophageal sphincter (LES) weakens and allows stomach acid to enter the esophagus.

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.

Hands holding a donut and a fancy coffee, representing common dietary triggers for heartburn.

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.

Open journal with a hand holding a pen, ready to write observations around heartburn symptoms.

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:

  1. Track your symptoms. Start by noticing which foods or habits are linked to your heartburn.

  2. Support digestion naturally. Try digestive bitters or apple cider vinegar before meals.

  3. Slow down while eating. Chew thoroughly, take deep breaths before meals, and avoid distractions.

  4. Avoid common triggers. Caffeine, high sugar diet, excessive processed carbohydrates, alcohol, spicy or fatty foods, and large meals are common culprits.

  5. Balance your gut. Consider probiotics, fermented foods, and a gut-supportive lifestyle.

  6. 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.


Love tips that help you feel better in your body? Get them delivered straight to your inbox with The Mindful Digest.


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

Azer SA, Hashmi MF, Reddivari AKR. Gastroesophageal Reflux Disease (GERD). In: StatPearls. Treasure Island (FL): StatPearls Publishing; May 1, 2024.

Chan WW, Sharma N, Gyawali CP. The Role of Gastroesophageal Reflux in Airway Inflammation. Am J Gastroenterol. 2025;120(1):60-64. doi:10.14309/ajg.0000000000003205

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/.

Sharma P, Yadlapati R. Pathophysiology and treatment options for gastroesophageal reflux disease: looking beyond acid. Ann N Y Acad Sci. 2021;1486(1):3-14. doi:10.1111/nyas.14501

Saha B, Vantanasiri K, Mohan BP, et al. Prevalence of Barrett's Esophagus and Esophageal Adenocarcinoma With and Without Gastroesophageal Reflux: A Systematic Review and Meta-analysis. Clin Gastroenterol Hepatol. 2024;22(7):1381-1394.e7. doi:10.1016/j.cgh.2023.10.006

Wang ZT, Tan WT, Huang JL, et al. Correlation Between Gastroesophageal Reflux Disease and Small Intestinal Bacterial Overgrowth: Analysis of Intestinal Microbiome and Metabolic Characteristics. J Inflamm Res. 2025;18:33-51. Published 2025 Jan 4. doi:10.2147/JIR.S487185

Smolka AJ, Schubert ML. Helicobacter pylori-Induced Changes in Gastric Acid Secretion and Upper Gastrointestinal Disease. Curr Top Microbiol Immunol. 2017;400:227-252. doi:10.1007/978-3-319-50520-6_10

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