5 Most Common Causes Of Heartburn

Heartburn is one of those symptoms many people accept as normal. You might laugh it off after a spicy meal or reach for the antacids in your nightstand without thinking twice. But like any symptom, heartburn is your body trying to tell you something.

Your body isn’t broken or working against you. It’s asking you to slow down and tune in.

Heartburn isn’t only about discomfort. Chronic acid reflux can disrupt digestion, damage your esophagus, and even affect your hormones and nervous system over time. Addressing the root causes can help you go beyond symptom management and support your gut, energy, and resilience.

While there are many potential contributors, these are 5 of the most common reasons you may be experiencing heartburn:

1. Low stomach acid, not high

2. Eating too quickly or while stressed

3. Overeating or eating large meals late at night

4. Food sensitivities and inflammatory triggers

5. Gut dysbiosis and microbiome imbalances

Here’s how these root causes connect to your body and how you can begin to address them.

1. Low Stomach Acid (Yes, Low)

It’s a common misconception that heartburn is always caused by too much stomach acid. In reality, low stomach acid (hypochlorhydria) is a frequent driver of reflux symptoms.

Here’s why: Stomach acid is needed to properly digest food and signal the lower esophageal sphincter (LES) to close after you swallow. When acid levels are low, the LES may remain partially open, allowing stomach contents to reflux into the esophagus, causing that burning sensation.

Additionally, low acid means food sits in your stomach longer, leading to fermentation, gas, and pressure that can push contents upward.

Contributors to low stomach acid include:

• Chronic stress

• Aging

• Long-term PPI or antacid use

• H. pylori infections

Action steps:

• Eat in a calm environment to support the “rest-and-digest” state.

• Chew food thoroughly to stimulate digestive enzymes.

• Consider apple cider vinegar or digestive bitters before meals (if appropriate for you).

• Work with a practitioner if you suspect H. pylori or chronic low acid.

2. Eating Too Quickly or While Stressed

Digestion starts in the mind before it begins in the stomach. If you’re eating on the go, scrolling your phone, taking bites between meetings, or eating while emotionally activated, your body is in sympathetic (“fight-or-flight”) mode, not the parasympathetic (“rest-and-digest”) state necessary for proper digestion.

When your body is stressed, it prioritizes survival, not digestion. This can lead to:

• Reduced stomach acid and enzyme production

• Incomplete breakdown of food

• Increased intra-abdominal pressure

• Poor signaling to the LES

All of these factors can trigger reflux and heartburn.

Action steps:

• Take a few deep belly breaths before meals.

• Sit down and eat without distractions.

• Chew each bite thoroughly before swallowing.

• Practice gratitude or mindfulness as you begin your meal to shift your body into a parasympathetic state.

3. Overeating or Eating Large Meals Late at Night

Eating large meals, especially close to bedtime, increases intra-abdominal pressure, making it easier for stomach contents to reflux into the esophagus, especially when lying down.

Additionally, your digestive system slows down at night as your body shifts into repair and restoration mode. Eating large, heavy meals late in the evening can disrupt this natural rhythm, leading to heartburn, bloating, and poor sleep.

Action steps:

• Eat your largest meals earlier in the day when digestion is strongest.

• Avoid lying down for at least 2-3 hours after eating.

• Opt for lighter, easily digestible dinners if you experience reflux at night.

4. Food Sensitivities and Inflammatory Triggers

Certain foods can relax the LES or increase inflammation in the gut, making reflux more likely. While triggers vary by individual, common culprits include:

• Caffeine

• Alcohol

• Chocolate

• Spicy foods

• Citrus

• Processed and fried foods

• Mint

Additionally, underlying food sensitivities (such as to gluten or dairy) can contribute to inflammation in the gut lining and slow digestion, indirectly contributing to reflux.

Action steps:

• Keep a food and symptom journal to identify your personal triggers.

• Temporarily remove common reflux-triggering foods to see if symptoms improve.

• Focus on whole, unprocessed foods that are easier to digest.

5. Gut Dysbiosis and Microbiome Imbalances

Your microbiome plays a significant role in digestion and motility. An imbalance in gut bacteria (dysbiosis) or conditions like SIBO (small intestinal bacterial overgrowth) can increase gas and bloating, leading to increased intra-abdominal pressure and reflux.

Dysbiosis can also contribute to inflammation in the gut lining and impaired digestion, which can perpetuate reflux symptoms.

Action steps:

• Increase plant diversity in your diet to support a healthier microbiome.

• Incorporate fermented foods if tolerated.

• Work with a practitioner to test for and address dysbiosis or SIBO if chronic reflux persists alongside bloating or irregular digestion.

Why Addressing Heartburn Matters

Heartburn isn’t just an inconvenience; chronic reflux can damage your esophageal lining, contribute to nutrient deficiencies, and reflect broader digestive dysfunctions that affect your energy, skin, hormones, and resilience.

Many people rely on acid-suppressing medications for symptom relief, but these do not address the root cause and can further reduce stomach acid, worsening the underlying problem over time.

If you’re looking for gentle, natural support while addressing the root causes, you might consider Hilma’s Occasional Heartburn + Indigestion. This herbal antacid relieves occasional heartburn and acid indigestion while promoting digestion, using a natural, drug-free formula made with five powerful ingredients to soothe the stomach. 

Your body is always communicating with you, even through heartburn. Supporting its messages with steadiness, stability, and compassion will always take you further than symptom suppression alone.