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You can feel heartburn, or acid reflux, coming from a mile away. That fierce and persistent burning sensation creeping up your throat. But what exactly causes this fiery phenomenon? "Acid reflux happens when the esophageal sphincter valve does not completely close or reopens after food passes through it to your stomach," says Niket Sonpal, MD, a gastroenterologist in New York City. The opening of the valve causes the acid within your stomach to move up to your esophagus, causing heartburn, chest pain, or acid indigestion.
It's pretty common, too. Acid reflux occurs in about 20% to 30% of the population, says Sonpal. Luckily, there are ways to prevent it—namely, avoiding reflux-inducing foods.
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"Certain foods increase your chance of getting acid reflux," says Sonpal. "This is due to the fact some foods relax the lower esophageal sphincter, which prevents the valve from fully tightening."
Generally, the foods that increase your risk of acid reflux are high in fat, increase saliva, and are highly acidic. Here are some specific foods to avoid.
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High-fat foods, including "healthy" choices like avocado, cause acid reflux because they stimulate a hormone that relaxes the lower esophageal sphincter.
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Chocolate is a triple threat. It can be high in fat and caffeine, plus it contains cocoa, another ingredient known to relax the lower esophageal sphincter.
Alcohol (yep, that includes wine) not only relaxes the lower esophageal sphincter but can also increase the amount of stomach acid in your body.
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Studies suggest people who add table salt to their food three times per week or more are over 50% more likely to experience acid reflux than those who do not.
Greasy or Fried Foods
Greasy food like takeout and fried foods tend to be very high in both fat and salt, both of which cause acid reflux.
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Because these foods—oranges, grapefruit, lemons—contain high amounts of acid, there's evidence they increase heartburn.
Spicy foods contain high amounts of capsaicin, a compound that slows digestion and thus can increase acid reflux.
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Mint may irritate the esophagus, leading to symptoms of heartburn.
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Onions relax the lower esophageal sphincter, which causes acid reflux.
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Soda not only contains caffeine, which can trigger acid reflux, but it also increases stomach acidity and can cause burping, something that can increase heartburn symptoms.
Unfortunately, though, avoidance doesn’t always provide adequate relief, especially in people who are more prone to acid reflux, says Sonpal.
In these instances, there are medications—and in extreme cases, surgeries—that help neutralize the acid in your stomach. Your doctor may initially prescribe antacids, says Sonpal. And if those do not work, they may give you foaming agents that coat your stomach or prokinetics that strengthen your lower esophageal sphincter, he explains. As a last resort, your doctor may place a metal ring, known as a Linx device, at the bottom of the esophagus or wrap the upper part of your stomach during surgery.
If you have extreme acid reflux, it's best to consult your doctor. Treatment varies per person, and persistent acid reflux can cause long-term health problems. "Stomach acid is very irritating to the lining of the stomach and esophagus," says Sonpal. "If left untreated, you may develop gastroesophageal reflux disease, a disease that can lead to long-term damage to the throat or, in extreme cases, cancer."