Why Does Heartburn Get Worse as You Age?

There was a time when a belly-buster breakfast or late-night pizza went down easy. But over the years, it seems something changed inside you … and now those meals regularly come with a side of heartburn.

That fiery feeling that moves up your chest can become a much more frequent issue as you age. So, why is that a later-in-life thing?

Let’s find out from gastroenterologist Claire Beveridge, MD.

Aging issues: What makes heartburn worsen over time?

Heartburn isn’t just a gift that comes with more birthdays. It can happen to anyone at any time during their life. For proof, check out these statistics from a global study on chronic heartburn in 2019.

The report shows that nearly 784 million people around the world experienced recurring heartburn, or gastroesophageal reflux disease (GERD). That roster even includes school-aged children.

But case counts clearly show that incidents of heartburn rise with age. Here are four reasons why:

1. Aging muscles

Muscles all around your body tend to weaken as you grow older — and that includes one that’s critical for preventing heartburn.

The muscle is essentially a valve known as the lower esophageal sphincter. Think of it as a gatekeeper between your esophagus and your stomach. It opens to let food you eat enter your stomach and then tightly shuts to keep it there.

“If that muscle weakens, it can have trouble keeping food and liquid where it belongs in your stomach,” explains Dr. Beveridge. “And when those contents break through and come back up into your esophagus, that’s when you feel heartburn.”

2. Weight gain

Most people add pounds as they add years to their age. Carrying extra weight can increase your chances of a meal ending in heartburn, says Dr. Beveridge.

One study found that the risk of GERD can double if your body mass index (BMI) reaches an unhealthy level. A larger waist size also can be a factor in whether you experience frequent heartburn.

“Extra weight can push down on your stomach, which creates pressure that helps push the food back up into your food pipe,” she adds.

3. Medications

Aging can bring health issues that lead to the need for medication, and those pills can light the match for heartburn. “Some medications can relax the esophageal sphincter, which makes that seal less tight,” notes Dr. Beveridge.

The list is extensive, too, ranging from over-the-counter pain relievers to antibiotics to blood pressure medications. Talk to your doctor about your options if certain medications seem to give you heartburn.

4. Hiatal hernia

By the time you reach the age of 60, there’s a more than 50-50 chance that a hiatal hernia appears on your medical chart. It’s a condition where the upper part of your stomach pushes up into your chest cavity.

There’s a much-studied connection between hiatal hernias and GERD. It appears that larger hiatal hernias increase your risk of frequent heartburn.

Ways to avoid heartburn

Want to keep those heartburn flames from igniting at any age? Try these tips.

• Watch what you eat. Certain food or drinks may spark heartburn. Spicy or fatty meals may haunt you later. Ditto for carbonated beverages, alcohol or caffeine-packed drinks. “Some people may be able to control their heartburn by avoiding their triggers,” says Dr. Beveridge.
• Don’t overeat. A loaded stomach is more likely to cause a heartburn-related backup.
• Drop excess pounds. Losing belly fat and improving your fitness can reduce pressure on your esophageal sphincter and lower your chances of heartburn.
• Avoid post-meal lounging. Hold off on lying down after eating for at least two hours. “If you’re upright, gravity will help keep things in your stomach,” states Dr. Beveridge. (If you use that time for a stroll, it may help with weight issues, too.)
• Change sleeping positions. If heartburn routinely wakes you up at night, try sleeping on your left side. This can help your digestive process. (Using a wedge pillow or raising the head of your bed so you sleep on a slight incline also may do the trick.)
• Don’t smoke. Need another reason not to light up? Well, nicotine can weaken your esophageal sphincter and open the door for heartburn.

How to treat heartburn

An occasional bout of heartburn is bound to happen. (Taco Tuesday can take a toll, right?) In those instances, an over-the-counter antacid — examples include Tums®, Rolaids® and Maalox® — or an H2 blocker, such as Pepcid® or Tagamet®, may offer some relief.

Now if you begin treating antacids as a regular after-meal dessert, it’s probably time to talk to your healthcare provider, says Dr. Beveridge. They may suggest a proton pump inhibitor such as Prilosec® or Nexium® to help control your GERD.

“Medications can play a role in terms of controlling heartburn,” she continues. “For proton pump inhibitors, they work the best if you take it on an empty stomach and eat something 30 to 60 minutes later.”

Reach out to your doctor if your heartburn occurs regularly or begins disrupting sleep. Swallowing issues that accompany heartburn also should be addressed immediately. Ditto for signs of bloody stool, unintentional weight loss or if heartburn first rears its head when you’re over the age of 60.

Heartburn symptoms aren’t always caused by acid reflux, after all. In less common cases, the symptoms can be a sign of:

• Barrett’s esophagus.
• Esophageal cancer.
• Gastroparesis.
• Eosinophilic esophagitis.

“The majority of the time, though, heartburn is related to acid reflux,” says Dr. Beveridge. “It can usually be taken care of with lifestyle changes or medications.”

To hear more on this topic from Dr. Beveridge, listen to the Health Essentials Podcast episode, “Tips to Extinguish Heartburn Pain.” New episodes of the Health Essentials Podcast publish every Wednesday.