Gut & DiscomfortOne of 9 articles on this topic

Heartburn: what helps right away, home remedies and diet

Burning behind the breastbone, acid regurgitation, worse at night? Almost everyone knows heartburn, and usually there's no drama behind it. Here's what helps in the next few minutes, which home remedies are backed by evidence, what you can eat and when to see a doctor.

Gregor AßlaberJoerg Hauke
Gregor Aßlaber, Editor, Saturo · ✓Fachlich geprüft von Joerg Hauke, Nutrition expert
Aktualisiert 30 September 2026 · 16 Min. Lesezeit · 96 Quellen
In 30 seconds
Frau steht abends in der Küche, drückt die Hand aufs Brustbein und hält ein Glas stilles Wasser
Heartburn mostly strikes in the evening: too much, too late, too fatty. What helps then is in chapter 4, and what you can change is in chapter 5.

The key points in 30 seconds

Get heartburn regularly
25out of 100

That's how many people get heartburn or acid regurgitation again and again, according to the German Federal Ministry of Health. 18% of adults in Germany report moderate to severe reflux symptoms. Occasionally it's harmless; once it happens weekly, it's called reflux disease.

Dinner shortly before bed
7x

That's how much higher the risk of reflux disease was in a case-control study when less than three hours lay between dinner and going to bed. The evening clock in chapter 5 works out the timings for your evening.

Until an antacid kicks in
2min

In a measurement study, antacids raised stomach pH after two minutes and a glass of water after one minute, but only for three minutes. An acid blocker like omeprazole takes hours to days. What makes sense when is in chapters 4 and 6.

Best sleeping position
Left & raised

People who lay on their left side at night had less reflux in 44% of cases in a randomised study, versus 24% in the control group. Raising the head end of the bed by 20 centimetres cut long reflux episodes from 3.3 to 1.0 per night.

01 Recognise

Recognising heartburn: symptoms, warning signs and how to tell it from a heart problem

Heartburn is a burning pain behind the breastbone: acidic stomach juice flows back into the oesophagus, whose lining has no protective layer. The culprit is almost never “too much acid”, but a valve that doesn't close properly: the lower oesophageal sphincter. This chapter shows you how to recognise heartburn, when it could be something else and which signs you should never sit out.

Heartburn symptoms: what it feels like

The 2023 DGVS guideline names three core symptoms: a burning behind the breastbone that can travel from the upper abdomen up to the throat, acid regurgitation and the feeling that stomach contents are coming back up, often with a sour taste in the mouth. Usually it happens after eating, when bending over, when lying down and at night. Throat clearing, hoarseness, cough, a lump in the throat and damaged tooth enamel can go with it, but don't have to: the guideline only calls them “associated”, and acid blockers often don't help with them. In a 2022 meta-analysis, one in two people with reflux disease had dental erosion, compared with one in five without.
Man at a desk after lunch, hand raised to his chest, burning feeling behind the breastbone
After lunch at the desk: the burning sits behind the breastbone, not in the stomach. What sets it apart from heart pain is in the table below.

Heartburn or heart: what you need to tell apart

A burning behind the breastbone can also come from the heart, and the German Heart Foundation explicitly warns against mixing the two up. The rule: pain that is stronger than anything you know, lasts longer than five minutes, or comes with shortness of breath, cold sweat and spreads to the arm, back or jaw is a case for 112, not for a glass of water.
At a glance

Heartburn or heart?

Both burn behind the breastbone. These features tell them apart. If in doubt, the right-hand column always wins.

More likely heartburnMore likely heart: call 112 now
WhenAfter eating, lying down, bending over, at nightSuddenly, even at rest or under exertion, longer than five minutes
What it feels likeBurning, rising, sour in the mouthPressure, tightness, “elephant on the chest”, feeling of impending doom
Where it spreadsFrom the upper abdomen behind the breastbone up to the throatTo the left arm, back, neck, jaw, shoulder blades, upper abdomen
What else comes with itBelching, feeling of fullness, cough or throat clearingShortness of breath, cold sweat, nausea, pale skin, fear
What helpsStanding upright, water, antacid: relief within minutesNone of these, or it comes back in waves
Especially in womenSameOften just tightness, nausea, upper abdominal or back pain, no classic chest pain scenario

Warning signs according to the German Heart Foundation (World Heart Day 2024) and the DGK. A heart attack can also start with “just” upper abdominal pain. If you're unsure, call. That's never wrong.

Silent reflux: throat clearing, hoarseness, lump in the throat, but no burning

“Silent reflux” (laryngopharyngeal reflux) means throat complaints without typical heartburn: constant throat clearing, hoarseness, an urge to cough, a lump in the throat. Online it's often described dramatically, but the DGVS guideline is more sober: these symptoms are “often wrongly attributed to reflux disease as the cause”, studies with high-dose acid blockers showed “no clear results”, and a meta-analysis of 72 studies found only a small advantage over placebo. If you have these complaints, go to an ENT practice first, not automatically onto long-term tablets.

How often is too often? The Montreal definition draws the line at “troublesome symptoms”, in practice at least once a week. From there it's called reflux disease, which affects 13% of people worldwide. According to the guideline, if you have typical heartburn without warning signs, you don't need a gastroscopy and can start treatment first: 88% are free of symptoms after four weeks of acid blockers. The warning signs below are why you should still take a look.
Warning signs

Does any of these apply to you?

No warning sign ticked. Then you can tackle your heartburn yourself first: chapter 4 for the next few minutes, chapter 5 for the next few weeks.

Not a diagnosis, but the alarm symptoms from the 2023 DGVS guideline in everyday language. With severe chest pain, shortness of breath or cold sweat: 112.
02 Causes

Causes of heartburn: why the valve doesn't hold tight

The gullet (oesophagus) opens into the stomach through a gap in the diaphragm, closed off by the lower sphincter. According to the guideline, heartburn happens in three ways: the muscle is permanently too weak, it relaxes spontaneously too often (usually when a big meal stretches the stomach), or part of the stomach has slipped up through the gap (hiatal hernia). Anything that raises pressure in the abdomen or loosens the ring can turn into heartburn.

Overweight, smoking, alcohol: what the numbers say

In the German Federal Health Survey of 7,124 respondents, people with overweight were 1.8 times more likely to have reflux symptoms, and people with obesity 2.6 times more likely; belly fat pushes the stomach against the ring. Losing weight works: in the HUNT study, the chance of being symptom-free doubled when BMI dropped by more than 3.5 points, and after losing 13 kilograms, 65% of people in an intervention study were symptom-free. Smoking raises the risk by a quarter. Alcohol loosens the ring: 48% higher risk according to a meta-analysis, and every extra small glass a day adds another 16%.

Heartburn from stress: more sensitive, not more acidic

Stress doesn't make more acid, it lowers your threshold for feeling it: under acute stress (noise), 46 reflux patients felt the same amount of acid in the oesophagus as a much stronger burning. Lack of sleep has the same effect: according to the guideline, even one night with three hours of sleep or less increases sensitivity to acid. And when you're stressed, you eat faster, eat more, eat later and drink more coffee or alcohol, so the triggers arrive all at once. That's why chapter 4 covers belly breathing: in a randomised study, it halved the time acid spent in the oesophagus.

Medicines that can trigger heartburn: The Pharmazeutische Zeitung names cortisone, painkillers from the NSAID group (ibuprofen, diclofenac, naproxen, aspirin) and calcium channel blockers for high blood pressure such as amlodipine; bisphosphonates for osteoporosis can damage the oesophagus directly, which is why they're taken standing up with plenty of water. In the worldwide meta-analysis, people who took NSAIDs regularly had a 44% higher risk; the German Federal Ministry of Health also lists the contraceptive pill. Don't stop anything on your own, but talk to your doctor: there's often an alternative or a better time to take it.
03 Understand

Three things that explain every case of heartburn

Once you know these three stages, you'll understand why a glass of water helps, why milk only helps briefly and why your last meal should be three hours before bed.

1

The valve

The lower sphincter and the diaphragm together form the barrier. It holds as long as the ring is closed and the pressure in your abdomen isn't higher than in your chest. A stretched stomach, fat, alcohol, nicotine and certain medicines make the ring open more often; belly fat, pregnancy and tight clothing push against it from below.

2

The acid pocket

After eating, a layer of pure acid that the food hasn't yet diluted sits at the top of the stomach, right under the ring. The later and bigger the meal, the longer it stays there, and when you lie down it reaches right up to the ring. Alginates lay a foam lid directly on top of it, which is why they work differently from antacids.

3

The lining

The oesophagus has no protection against acid, but it does have a cleaning system: every swallow and your saliva wash the acid back into the stomach. When you sleep, both are missing, which is why the burning lasts longer at night. Chewing gum, standing upright and a sip of water speed up the cleaning; stress and lack of sleep lower your threshold, so the same acid burns more.

04 Quick relief

What helps with heartburn right away: the first minutes and home remedies put to the test

What helps against heartburn right away

Three things help within minutes. First, stay upright: standing, gravity pulls the acid down, while bending over and lying down keep it at the ring. Second, a glass of still water in small sips: in a measurement study, it raised the stomach pH above 4 within a minute in 10 of 12 people, but only for three minutes; it does rinse the oesophagus clear, though. Third, antacids or alginate: antacids worked after two minutes, while alginates lay a foam lid on the acid pocket within seconds. Afterwards, loosen your belt, chew sugar-free gum and don't lie down until it's gone.

Home remedies for heartburn: what really helps and what's just habit

There are hardly any topics with so many home remedies and so few studies; a 2019 review sees “a considerable gap” between what people say and what's proven. We checked every common home remedy: three are well supported (water, chewing gum, belly breathing), two are riskier than they sound (baking soda, apple cider vinegar), and the rest is based on experience. For oats, almonds, potato juice, linseed mucilage and healing clay, there isn't a single reflux study on PubMed: not ineffective, just never measured.
Home remedy check

Twelve home remedies, ranked by evidence

What studies show, what's only experience and how to use each remedy properly.

EvidenceWhat was measuredHow to use it
Still waterProven, short-termStomach pH above 4 after 1 minute, for 3 minutes; flushes the oesophagusOne glass in small sips, staying upright
Sugar-free chewing gumProvenSaliva doubles, acid cleared in 2.3 instead of 6.9 minutes; less acid exposure time after eatingChew for 30 minutes after the meal, not peppermint if you're sensitive
Belly breathingProven (RCT)Four weeks of training halved acid exposure time in the oesophagus (9.1 to 4.7%)10 minutes daily, hand on your belly, breathe in deeply, out slowly
Head of bed raised, lying on your leftProven (RCT)20 cm elevation: long reflux episodes down from 3.3 to 1.0 per night; left-side position 44% instead of 24% successBlocks under the bed legs or a wedge, not just pillows; details in chapter 7
Antacid, alginateProvenAntacid works after 2 minutes; alginate eliminates the acid pocket after late mealsAfter eating and before bed, leave 2 hours between this and other medication
MilkBriefly yes, then noBuffers briefly thanks to its pH; 240 ml then stimulated acid production to 20 to 35% of the maximum, even low-fatAt most one small glass of low-fat, not a go-to remedy
Baking sodaWorks, riskyNeutralises immediately, releases carbon dioxide; case reports of stomach ruptures after baking soda on a full stomach; 1 teaspoon contains around 1.4 g sodiumOnly in exceptional cases, half a teaspoon in water, never after a big meal, not with high blood pressure, not during pregnancy
Oats, rusks, almondsExperienceNo reflux study; porridge is low in fat and mild, almonds are half fatSmall amount, chew slowly; sensible for breakfast, unproven as a quick fix
Chamomile, fennel, gingerExperienceNo study on chamomile and fennel; ginger sped up stomach emptying without changing symptomsWarm, unsweetened; ginger only in mild doses
Healing clayManufacturer dataApproved as an antacid; the only evaluation is a manufacturer-funded observational studyUse it like an antacid, leaving a gap between it and medication
Honey, turmericNot provenHoney: one pilot study with 30 people; turmeric: study on irritable stomach without placebo, not on heartburnFine as a treat, not as a remedy
Apple cider vinegarNot proven, acidicNo intervention study; pH 2.4 to 3.4 irritates the mucous membrane and tooth enamelSkip it

Sources: Karamanolis 2008, von Schönfeld 1997, Moazzez 2005, Eherer 2012, Khan 2012, Schuitenmaker 2022, Ippoliti 1976, Han 2022, Hu 2011, Ahuja 2019, Gośliński 2023, Kongkam 2023. PubMed search 22/09/2026.

Does milk help with heartburn?

For two minutes. Milk has a pH of around 6.5, dilutes and cools, which is why the first sip feels good. After that the effect flips: in a classic study, a glass of milk (240 millilitres) stimulated acid production to 20 to 35% of the maximum, whole, low-fat and fat-free alike; protein and calcium are the triggers, not the fat. So at breakfast, low-fat milk is no problem, but as a fire extinguisher, still water is the better choice.
Baking soda for heartburn

Baking soda neutralises acid abruptly, the stomach hits back with more, and carbon dioxide is produced: of 36 spontaneous stomach ruptures in one review, 10 happened after baking soda on a big meal. The Pharmazeutische Zeitung calls baking soda “obsolete”; an antacid is just as fast and safer.

Tea for heartburn: which one, and which not

Black tea didn't trigger reflux in a measurement study, unlike coffee; only from six cups a day did the risk rise by a quarter in the Nurses' Health Study. Chamomile and fennel have no study behind them, but they're caffeine-free, warm and mild, the sensible evening drink. Peppermint tea is on every trigger list; the only measurement study found no effect on the sphincter, only irritation symptoms at a high dose: if you tolerate it, you can drink it. Skip sweetened ready-made iced tea: at pH 2.9 it's as acidic as cola.
Young woman standing upright at the kitchen window sipping still water, with oats, almonds and chewing gum next to her
Stay upright, sip still water, then chew gum: the three quick fixes with evidence behind them. The oats are for breakfast, not for putting out the fire.
05 Food

What to eat with heartburn: food traffic light, evening clock and a day with no banned list

The most important thing first: the DGVS guideline states that there is "no specific anti-reflux diet" and that cutting out chocolate, coffee, spicy food, citrus or fat is "not conclusively and universally proven". What is well proven is the how: smaller (an 800 ml meal instead of a 500 ml one brought four times as much acid into the oesophagus), slower (eaten in five minutes instead of 30: 14 reflux episodes instead of 10), earlier (three hours before lying down) and lower in fat, higher in fibre. The food traffic light rates 70 foods.
Interactive

Food traffic light: is it OK with heartburn?

Type in a food or filter by group. Green usually means well tolerated, yellow means portion size and timing decide, red means a common trigger in studies. What applies to you, only your own test will show.

  • Still water tap water AlwaysNo effect on the sphincter; two glasses instead of coffee or soft drinks slightly lowered the risk in one cohort.
  • Sparkling mineral water fizzy water TestCarbonation lowers sphincter pressure by 30 to 50% for 20 minutes; there's no proven link to symptoms.
  • Cola Cola Zero, lemonade, soft drinks AvoidpH 2.4, carbonation, sugar; the most common drink trigger (40%) in a survey of 4,400 sufferers. Cola Zero is just as acidic.
  • Coffee espresso Up to 2 cupsEvidence is mixed: meta-analyses find hardly any risk, while one measurement study found more reflux than with tea. Not on an empty stomach, not in the evening.
  • Decaffeinated coffee caffeine-free TestDecaffeinating clearly reduced reflux in the measurement study; caffeine isn't the driver, other compounds in coffee are.
  • Black tea green tea Up to 6 cupsDidn't trigger reflux in the measurement study; only from six cups a day did the risk rise in the Nurses' Health Study.
  • Bottled iced tea ready-made iced tea AvoidpH 2.85 to 2.93, as acidic as cola, plus sugar.
  • Peppermint tea mint TestOn every trigger list; the only measurement study found no effect on the sphincter, just irritation at high doses.
  • Chamomile tea fennel tea, herbal tea AlwaysNo study, but caffeine-free, warm and mild: the sensible evening drink.
  • Ginger tea ginger Mild doseGinger sped up stomach emptying; in healthy people, 1 g of powder relaxed the sphincter. Brew it weak.
  • Orange juice lemon juice, grapefruit juice AvoidAcidity correlates with heartburn; 31% of sufferers named orange juice as a trigger.
  • Apple juice juice spritzer DilutedpH 3.4 to 4.0; juice was neutral in the cohort. Dilute it well and don't drink it on an empty stomach.
  • Milk full-fat milk Small glassBuffers briefly, then stimulates acid (low-fat too); fat content correlated with heartburn.
  • Low-fat milk skimmed milk, oat milk With mealsNot linked to symptoms in the cohort; low in fat. Oat milk hasn't been studied, but it's low in fat and mild.
  • Beer AvoidIn reflux patients, 25% instead of 11% acid time after half a litre; fermentation compounds stimulate acid.
  • Wine white wine, red wine AvoidWhite wine: 13% instead of 1% acid time in the first hour in healthy people, 23% instead of 12% in sufferers.
  • Sparkling wine prosecco AvoidFermented plus carbonated, and both are proven to promote reflux.
  • Alcohol-free beer TestNot studied; reflux from beer doesn't depend on the alcohol but on fermentation compounds. Probably hardly better than regular beer.
  • Spirits schnapps, whisky, gin AvoidAlcohol raises the risk by 48%, and each additional small glass by 16%.
  • Banana AlwayspH 4.5 to 5.2, 0.3 g fat. No study, but mild and in almost every recommendation.
  • Honeydew melon watermelon, cantaloupe AlwayspH 6.0 to 6.7, almost neutral and high in water.
  • Pear AlwaysMild, 3 g fibre per piece; if your gut lining is very sensitive, go for ripe and peeled.
  • Apple apple sauce Sweet varietypH 3.3 to 4.0, slightly sour; "an apple neutralises acid" isn't proven. Sweet, ripe varieties are usually tolerated.
  • Grapes Small amountpH 2.9 to 3.8 and 15 g sugar per 100 g; no study, but the acidity points to small portions.
  • Pineapple Small amountpH 3.2 to 4.0; there's no proof that the enzyme bromelain helps with reflux. Try it fresh and in small amounts.
  • Orange grapefruit, citrus fruits, mandarin Test36% of sufferers name citrus as a trigger; according to the guideline, cutting it out isn't generally proven to help. Not in the evening.
  • Blueberries berries AlwaysMild and high in fibre; strawberries and raspberries are more acidic, so keep the portion small.
  • Avocado Half a fruitpH 6.3 to 6.6, so low in acid, but 15 g fat per 100 g. Half an avocado at lunch is fine, a whole one late in the evening isn't.
  • Tomato raw TestpH 4.3 to 4.9; tomato juice triggered symptoms in one study, even though it's milder than other juices.
  • Tomato sauce ketchup, pizza sauce AvoidConcentrated, pH 3.9, often with fat and sugar.
  • Raw onions AvoidA slice of raw onion clearly increased reflux episodes and heartburn in sufferers, but not in healthy people.
  • Onions, steamed garlic TestThe study only covered raw onions; many people tolerate them steamed. Garlic is based on experience.
  • Potatoes baked potato, mashed potato Always0.1 g fat, pH 5.4 to 5.9; the basis of every bland diet. Mash them without cream and a mountain of butter.
  • Potato salad Without mayoWith vinegar and mayonnaise it's an acid-and-fat package; dressed with stock, it works.
  • Sweet potato AlwaysLow in fat, 3 g fibre per 100 g.
  • Broccoli carrots, courgettes, spinach, pumpkin SteamedLow in fat, pH 5.6 to 7.2; vegetables are part of the eating pattern linked to less reflux.
  • Mushrooms button mushrooms SteamedpH 6.0 to 6.7, low in fat; breaded or in a cream sauce, that no longer applies.
  • Pulses lentils, beans, chickpeas TestHigh in fibre, which speaks in their favour; bloating raises pressure, which speaks against them for some people.
  • Low-fat plain yoghurt yoghurt Always1.6 g fat; dairy was neutral in the cohort. Unsweetened.
  • Skyr low-fat quark, quark Always0.4 to 1 g fat and 10 to 12 g protein per 100 g; high-protein and low-fat is considered favourable in dietary recommendations. No study, no healing effect.
  • Fruit yoghurt cream yoghurt, pudding Small portionSugar and fat; the guideline advises cutting back on both.
  • Cottage cheese light cream cheese AlwaysLow in fat, pH 4.8 to 5.0.
  • Cheese hard cheese, Camembert, cream cheese Small portionHigh in fat; one genetic study even linked cheese to less reflux. No reason to cut it out, just watch the portion.
  • Cream butter, cream sauce SparinglyFat correlates with heartburn, and when you lie down, fat clearly prolongs the time acid sticks around.
  • Chocolate milk chocolate, nougat Avoid120 ml of chocolate syrup lowered sphincter pressure from 14.6 to 7.9 mmHg; more acid in the oesophagus after eating. Whether cutting it out eases symptoms is unclear.
  • Dark chocolate plain, 70% 20 g, not in the eveningNo dedicated study, no evidence that it's easier to tolerate; 43 g fat per 100 g.
  • Cocoa cocoa powder, hot chocolate With skimmed milkCocoa contains methylxanthines, which are thought to relax the sphincter; unsweetened powder has 14 g fat per 100 g, and a teaspoon is not much. Not in the evening.
  • Honey TeaspoonpH 3.7 to 4.2, 82% sugar; not proven as a remedy for heartburn.
  • Gummy bears boiled sweets, sweets Small amountSugar; the guideline recommends cutting back on sugar.
  • Cake croissant, doughnut AvoidFat and sugar together, often in a large portion.
  • Rolled oats porridge, oat gruel AlwaysLow in fat, high in fibre, pH 6.2 to 6.6; a high-fibre diet cut heartburn from 93 to 40% in a small study. No oat-specific study, but plausibly good.
  • Wholemeal bread rye bread AlwaysHigh-fibre bread was linked to less reflux in the HUNT study. Chew well.
  • White bread toast, bread rolls Try and seeNo proven benefit; fresh yeast bakes make some people bloated.
  • Zwieback rusks Try and seeA bland-diet classic, but 10 g fat and 12 g sugar per 100 g; "binds acid" is not proven.
  • Rice millet, quinoa, couscous AlwaysLow in fat, mild; a base for a light evening plate.
  • Pasta noodles Without a fatty saucePasta itself is fine; cream, tomato and cheese sauces are not.
  • Pizza Avoid12 g fat per 100 g, and a whole pizza brings 43 g fat and lots of volume, plus tomato sauce.
  • Chips fried food, breaded schnitzel Avoid72% of sufferers name fatty food as a trigger; fried food is part of the unfavourable eating pattern.
  • Chicken breast turkey, cod, pollock Always3 g fat per 100 g; poultry and fish are part of the pattern linked to less reflux.
  • Salmon oily fish Small portion12 g fat per 100 g, but good fats; better at lunchtime than in the evening.
  • Pork belly bacon, salami, fatty sausage Avoid30 to 53 g fat per 100 g; red and fatty meat is part of the unfavourable pattern.
  • Eggs scrambled egg, boiled egg Without much fatFine boiled or poached; fried in butter or with bacon, it becomes a fatty meal.
  • Mayonnaise remoulade Avoid75 g fat per 100 g.
  • Peanut butter nut butter One tablespoon51 g fat per 100 g; a tablespoon is fine, half the jar is not.
  • Olive oil rapeseed oil One teaspoonPart of the Mediterranean pattern linked to less reflux; the amount counts, and a teaspoon is 5 g fat.
  • Almonds walnuts, nuts HandfulHalf fat; "almonds neutralise acid" is not proven. 20 g as a snack, not late in the evening.
  • Linseed chia seeds One tablespoon27 g fibre per 100 g; the mucilage effect comes from experience, fibre is the real argument.
  • Chilli cayenne, hot curry, Tabasco Avoid3 g chilli a day doubled the acid score; capsaicin makes the lining more sensitive, so the burning kicks in twice as fast.
  • Pepper sweet paprika, mustard ModerateMost people tolerate mild heat; mustard and vinegar are acidic.
  • Turmeric cinnamon, parsley, basil, herbs AlwaysMild; turmeric helps with an irritable stomach, it's not proven for heartburn, but it's fine as a spice.
  • Vinegar balsamic, apple cider vinegar SparinglypH 2.4 to 3.4; apple cider vinegar as a home remedy has no study behind it and is irritating.
  • Salt adding extra at the table LessPeople who always add extra salt had a 1.7 times higher risk in the HUNT study.
  • Bicarbonate of soda baking powder, Kaiser Natron Exceptions onlyIt works, but: there are cases of stomach rupture after taking it on a full stomach, and a teaspoon has 1.4 g sodium. An antacid is safer.
  • Healing clay Heilerde Like an antacidApproved as an acid binder; the only analysis is manufacturer-funded.
  • Sugar-free chewing gum After eatingDoubles saliva; acid is cleared in 2.3 instead of 6.9 minutes.
  • Potato juice oat gruel, linseed mucilage ExperienceNo study on reflux; if you find it soothing, go ahead.
  • Black seed oil Not provenOnly one study on irritable stomach, none on heartburn; it's fat.
Assessment based on measurement studies (oesophageal pH, sphincter pressure), cohorts and nutritional data (USDA, FDA pH table); sources at the end. Not a diagnosis, not a diet prescription.

Avocado and heartburn

With a pH of 6.3 to 6.6, avocado is almost neutral, so it doesn't irritate on the way down. What counts against it is the fat: 15 grams per 100 grams, and a whole fruit brings 25 to 30 grams. Fat keeps a meal in the stomach for longer; when lying down, a high-fat meal raised acid time from 0.7 to 7.6%. There's no avocado study. The answer comes down to quantity: half an avocado on wholegrain bread at lunchtime is fine, guacamole with crisps at 11pm is not, and there the avocado isn't the problem.

Cocoa and chocolate and heartburn

120 millilitres of chocolate syrup lowered sphincter pressure in healthy people from 14.6 to 7.9 mmHg, and in people with an inflamed lining, chocolate after a meal measurably brought more acid into the oesophagus. The culprits are methylxanthines (caffeine, theobromine) and fat; the serotonin explanation you see online isn't in any study. Whether cutting it out helps is an open question, as symptom studies are missing. Dark chocolate isn't proven to be easier to tolerate, and it has more fat. Cocoa powder has the least, at 14 grams of fat per 100 grams; a teaspoon in skimmed milk is the mildest form. Rule of thumb: 20 grams, not in the evening, see how you get on.

Cola and heartburn

Cola “settles the stomach”? The measurements say the opposite. Cola has a pH of 2.4, more acidic than any fruit juice, and its carbonation lowered sphincter pressure in healthy people by 30 to 50% for about 20 minutes, and in 62% of them down to the range where the ring no longer closes tightly. In a survey of 4,400 people with heartburn, soft drinks were the most frequently named drink trigger. A review article from 2010 found no evidence of lasting damage; it's just that “brief” is the wrong thing to have when your heartburn is acute. Cola Zero is just as acidic and just as fizzy.

Coffee and heartburn

Coffee has the most contradictory research. Two meta-analyses find little or only a small link (18% more reflux, “of unclear clinical significance”), and in the Nurses' Health Study the risk only rose from six cups. In the only measurement study, though, coffee triggered clearly more reflux than tea or water, decaffeinated clearly less, while caffeine in water did nothing: it's not the caffeine, it's other compounds in coffee that drive it. In practice: up to two cups, not on an empty stomach, not after 4pm, and if you have symptoms, try decaf first.
Top-down view of a reflux-friendly day: porridge with banana, baked potato with chicken and steamed vegetables, yoghurt with pear, ginger tea, still water, toast and almonds
A day with no banned list: porridge, baked potato with chicken and vegetables, yoghurt with pear, plus water and ginger tea. Low in fat, small portions, and none of it after 7:30pm.

What to have for breakfast with heartburn: Have breakfast, first things first. People who skip it had a 2.7-fold higher risk of reflux disease in a Chinese cohort and a 2.5-fold higher risk in the UK Biobank. Then keep it low in fat and high in fibre: porridge with banana (367 kilocalories, 4 grams of fat), low-fat plain yoghurt with berries, wholegrain bread with cottage cheese. Not the hotel breakfast of croissant, coffee on an empty stomach and orange juice.

What to eat in the evening with reflux

In the evening, two rules matter more than any food list: timing (three hours before lying down) and portion size (small). Low-fat and high-protein works: skyr with pear and oats, clear vegetable soup with chicken, rice with vegetables and fish, a herb omelette. Wine, beer and chocolate to finish are the clearest reflux triggers in measurement studies. And if it's got late: better the small meal than the big plate, better nothing than the midnight snack.
Interactive

When is your last meal today?

Pick your bedtime and the evening clock converts the rules from studies and guidelines into a plan for your evening.

When do you go to bed?
  1. –
    1Last big meal

    Less than three hours between dinner and bed meant a 7.45 times higher risk of reflux disease in a case-control study; the guideline lists skipping late meals as effective against night-time acid.

  2. –
    2Small snack, if needed

    Banana, rusk or a spoonful of skyr, no more than a handful. The midnight snack carried 5 times the risk in observational studies.

  3. –
    3Only still water or herbal tea

    No more coffee, alcohol or fizzy drinks: all three relax the sphincter or bloat the stomach.

Pick your bedtime above.

Guide values from Fujiwara 2005, Piesman 2007, Zhang 2021 and the DGVS guideline 2023, not a diagnosis. If you still get heartburn at night regularly, talk to your doctor.

Small meal instead of a big plate: There are evenings when the evening clock says 19:30 and you only get home at 19:15. Then it's not about the perfect dinner, but about what's small, low in fat and quick.
Woman drinking a small sip of Saturo drinkable meal Natural from a glass at the kitchen counter in the evening
Home late, evening clock almost run out: a small, quiet meal drunk in peace, instead of the big plate at 9pm.

Three things speak for a small liquid meal: liquids leave the stomach without the lag phase of solid food, 400 millilitres stretch it less than a full plate with a drink, and without carbonation the sphincter is left in peace. Nobody has studied whether this measurably reduces heartburn, so we don't promise it. A Saturo drinkable meal is a complete meal with 400 kilocalories in a small, still volume, with the same rules as any other: three hours before bed, upright, no rush.
Ready-to-Drink 6 x 400 ml
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06 Medication & doctor

When home remedies aren't enough: heartburn medication and when to see a doctor

Which tablets help with heartburn

Four groups of active ingredients, differing in how fast and how long they work. Antacids (magaldrate, hydrotalcite) neutralise the acid in two minutes. Alginates form a foam raft on top of the acid pocket within seconds; according to the guideline, the only over-the-counter remedy that clears the acid pocket after a late meal, and over 14 days not inferior to an acid blocker. H2 blockers (famotidine) reduce acid production after 30 to 60 minutes for six to ten hours; ranitidine has been off the market since 2021. Proton pump inhibitors (PPIs: omeprazole, pantoprazole) switch off the acid pumps, take hours to days and are the treatment of choice for weekly heartburn or an inflamed lining.
At a glance

Four groups of active ingredients compared

What works how fast, how long you can take it without a prescription, and what it's meant for.

AntacidsAlginatesH2 blockersPPIs
Active ingredientsMagaldrate, hydrotalcite, calcium carbonate, magnesium hydroxideSodium alginate plus antacidFamotidineOmeprazole, pantoprazole, esomeprazole
Onset2 minutesSeconds to minutes30 to 60 minutesHours, full effect after 2 to 3 days
Duration1 to 3 hours after eatingSeveral hours6 to 10 hoursRound the clock
Over the counterYes, max. 2 weeks without adviceYesOnly 10 mg, max. 14 days20 mg, once daily, max. 14 days
Good forAcute heartburn, occasionalAfter eating and before bed, acid pocket, pregnancyPrevention in the eveningWeekly heartburn, inflamed lining
Points to noteLeave 2 hours between this and other medicationContains sodium or calcium, check the packLess effective than PPIsMorning before breakfast, taper off gradually when stopping

Onset times according to Karamanolis 2008 (pH measurement), PTA-Forum 2007, Mandel 2000; over-the-counter rules according to the German Prescription Medicines Ordinance (AMVV), Annex 1 (as of 2026). No brand recommendation; your pharmacy knows the right form.

Pantoprazole and omeprazole: how long, how to take them, how to stop

Taking them: one 20 mg capsule in the morning before breakfast, swallowed whole, because the pellets are only released in the gut; the effect builds up over two to three days, and a PPI is not an emergency remedy. How long without a prescription: 14 days under the German Prescription Medicines Ordinance; after that, the question belongs with your doctor, not in the next pack.

Why you shouldn't just stop: Afterwards, your stomach temporarily produces more acid. Of 120 healthy people, 44% had acid-related symptoms after eight weeks of PPI once they stopped, compared with 15% on placebo. That's why the guideline recommends tapering off; antacids or alginate help on breakthrough days. Long-term: Since 2012, the prescribing information has warned about bone fractures and magnesium deficiency. The largest randomised trial (17,598 people, three years), however, found no difference in fractures, kidney disease, dementia or cancer, only slightly more intestinal infections. The guideline's verdict: the risk is low, but only take them for as long as there's a reason to. Omeprazole and pantoprazole are equally effective; pantoprazole has fewer interactions.

Tablets take away the acid, not the cause. If you stop your acid blocker and carry on eating late and big, you're back at square one after two weeks. The evening clock and the smaller portions are the part no capsule can replace.

Joerg Hauke, Nutrition expert, specialist review of this article

When to see a doctor about heartburn

Straight away if you notice the warning signs from chapter 1: difficulty swallowing, pain when swallowing, unintended weight loss, repeated vomiting, blood, iron deficiency. Call 112 for chest pain lasting more than five minutes with shortness of breath, cold sweats or pain spreading to other areas. Book an appointment if heartburn lasts longer than two weeks despite over-the-counter remedies, comes at least once a week, wakes you at night, or you take medication that can trigger it. Once in your life, get a gastroscopy if you've had heartburn on and off for years; that's how the guideline rules out Barrett's oesophagus, because 40% of people with oesophageal cancer had no severe symptoms beforehand.

What happens at the doctor's: The old "PPI test" (two weeks of tablets as a diagnosis) is considered "unusable" according to the guideline: it only identifies 71% of people who have reflux and gives a positive result in 44% of those who don't. The diagnosis is made reliably with a gastroscopy (inflammation, Barrett's, hiatus hernia) and, if that shows nothing unusual, with a 24-hour acid measurement: acidic for more than 6% of the time means reflux disease. Surgery (fundoplication) is only an option if the reflux is confirmed and tablets don't help.
07 Special cases

Heartburn at night, in pregnancy, during the menopause and in children

Heartburn at night: why it gets worse when you lie down

During the day, your oesophagus clears acid away within minutes: you swallow about once a minute, saliva buffers the acid, and gravity helps. In your sleep, all of that is missing, and a pocket of acid from a late meal can reach the sphincter when you're lying down. That's why night-time reflux episodes last longer, and according to the guideline, people affected are more likely to develop inflammation of the lining and sleep worse; lack of sleep makes the lining more sensitive, a vicious circle. If it burns at night: sit up, take a few sips of still water, grab an alginate or antacid from your bedside table, and don't lie flat again.

For the night, the studies are clearest. First, the gap: the evening clock in chapter 5 works out the three hours for you. Second, the head end: when 20 patients raised the head of their bed by 20 centimetres, long reflux episodes fell from 3.3 to 1.0 per night. Tilt the whole bed (blocks under the feet, a wedge under the mattress), not just your head: a high pillow bends your belly. Third, the side you sleep on, with the best study on the whole topic: randomised, double-blind, 100 patients in Amsterdam.
On your right or on your back 24%

of patients with night-time reflux had markedly fewer symptoms after two weeks (12 of 50). They wore the same device, but it didn't respond

Sleeping on your left, trained 44%

succeeded when a sensor woke them as they lay on their right, raising time on the left side from 39 to 61% (22 of 50). Your stomach sits on the left, so the acid stays below the sphincter. Without a sensor, a pillow behind your back helps

Heartburn in pregnancy

Of 510 pregnant women in a German study, 26% had reflux symptoms in the first trimester, 36% in the second and 51% in the third. Progesterone loosens the sphincter and the growing womb pushes the stomach upwards; both go away after the birth. Until then, according to the guideline and Embryotox: start with small meals, a three-hour gap, sleeping on your left and a raised head end; then antacids and alginates, permitted "for a short time at the usual dose"; then prescribed sucralfate, H2 blockers or PPIs. Omeprazole is the best studied, with around 5,000 documented pregnancies, and according to Embryotox the "drug of choice". Not baking soda.

Heartburn during the menopause

Can heartburn be hormonal? There's no evidence that the menopause itself triggers heartburn. For hormone replacement therapy, there is: in the Nurses' Health Study (51,637 post-menopausal women), users of oestrogen alone had a 1.66 times higher risk of reflux, and a 2023 meta-analysis found 29% more reflux with hormone therapy. If your heartburn starts with hormone therapy, bring it up at your next appointment.

Heartburn in babies and children: Spitting up in infants isn't heartburn, it's normal: of 948 parents surveyed, half saw it every day in the first three months, and 5% still did at one year old. The paediatric guideline advises against acid blockers for thriving babies who spit up. Get it checked if there's poor weight gain, bilious or bloody vomit, refusal to feed or breathing problems. Older children with genuine heartburn get the same advice as adults, with medication only through a paediatrician.
08 Reference

Common questions about heartburn

What helps quickly against heartburn?

Stay upright, sip a glass of still water, then take an antacid or alginate: antacids work after two minutes, and water raised stomach pH after one minute. Afterwards, chew sugar-free gum; it flushes the acid away three times faster. Don't lie down, no fizzy drinks, and no milk to put out the fire.

Can heartburn cause heart rhythm problems?

There's a statistical link, but no proof of a cause. In a Swedish study of 118,000 reflux patients, 6.0% developed atrial fibrillation, compared with 6.9% without reflux; once adjusted, a 1.13 times higher risk remained, and a 2025 meta-analysis found 1.27 times. Heart palpitations should be checked out, not put down to heartburn.

Does drinking water help with heartburn?

Yes, briefly. A glass of water raised stomach pH above 4 in 10 of 12 healthy people within a minute, for about three minutes; above all, it flushes the acid back down out of the oesophagus. Still water, small sips, upright. Carbonation loosens the sphincter for 20 minutes.

Does magnesium help with heartburn?

As an antacid, yes: magnesium hydroxide is an active ingredient in antacids, but it has a laxative effect and is therefore combined with aluminium salts. As a food supplement, no: no study shows that magnesium capsules improve heartburn. Conversely, long-term PPI use can cause a magnesium deficiency, which the prescribing information has warned about since 2012.

Is turmeric good for heartburn?

Not proven. The much-cited 2023 study in which turmeric worked as well as omeprazole looked at irritable stomach, not reflux, and had no placebo group. A 2024 review calls the results for digestive complaints "inconsistent". Fine as a spice, but there's no data for it as a remedy for heartburn.

What is the 3-finger trick for heartburn?

A social media trend using acupressure: three finger-widths above the wrist crease sits the Neiguan point (PC 6), used in Chinese medicine against nausea. There's no study on it for heartburn; for needle acupuncture, there's only one small, unblinded study with 30 people. It won't hurt to try, but there's no evidence.

Why do I always get heartburn at night?

Because lying down means the natural cleaning stops: during the day, swallowing, saliva and gravity wash the acid back down, but not while you sleep. An acid pocket from a late meal can then reach all the way up to the sphincter. What's proven to help: have your last big meal three hours before bed, raise the head of your bed by 20 centimetres, and sleep on your left side (44% instead of 24% success).

Is alcohol-free beer good for heartburn?

Not studied, and the physiology argues against it: beer doesn't trigger reflux through the alcohol, but through fermentation compounds that strongly stimulate acid production. Alcohol-free beer has those too, plus carbonation. If you tolerate it, go ahead and drink it, but it's not a remedy.

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Gregor Aßlaber
Gregor AßlaberAuthor · Editor, Saturo

Has been writing for Saturo since 2019 about nutrition, nutrients and how to get properly nourished in everyday life.

Joerg Hauke
Joerg HaukeFachliche Prüfung · Nutrition expert

Hat diesen Artikel am 23. September 2026 auf fachliche Richtigkeit geprüft. The content does not replace medical advice.

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