Why water can give you heartburn
Sure, you can get heartburn from a particularly spicy meal, or just by chowing down a bit too generously (Thanksgiving dinner, anyone?). But water?! Yep, even the stuff that's supposed to be good for you in almost all cases can trigger a bout of heartburn. Once you understand why, you'll know how to stay hydrated without having to suffer the consequences.
Why even water can cause heartburn
Heartburn is the result of acidic liquid (usually chyme, or partially-digested food) from your stomach entering your esophagus, or the tube that connects your mouth to your stomach. Normally, a valve called the LES (lower esophageal sphincter) maintains a barrier between the esophagus and the stomach, so that the latter's acidic contents don't spill into the esophagus. The stomach and LES are protected from acid; the esophagus is not.
The LES opens when you swallow food or drink, so that what you consume can enter your stomach. It also occasionally opens momentarily when there's pressure in your stomach from trapped gas, so you can burp/belch it out. Sometimes, however, it will open up when it shouldn't, like when the stomach is very full, or when there's pressure on the stomach (like from clothing that's too tight around your waist). In that case, the acidic liquid can overflow into your esophagus, and you feel pain.
So why can water trigger this? There are two primary reasons:
- Your stomach might still be filled with chyme from a recently-eaten meal. Drinking some water might add more volume to your stomach contents, and pressure on your stomach which might trigger the LES to open.
Imagine a bowl filled with soup. If you were to add a cup of water to that full bowl, what would happen?
- If your stomach is empty and you drink a large volume of water, the water itself can fill your stomach enough to cause the LES to open. Distension (swelling) of the stomach causes it to release acid, which mixes with the water, resulting in an acidic liquid which can enter the esophagus and also cause heartburn.
The human stomach is, on average, the size of a fist, and has an average capacity of 900 ml (about 30 fluid ounces, or just shy of 4 cups). While your stomach can stretch beyond this, in most cases it's not advisable because you will feel uncomfortably stuffed.
What you can do
What's often recommended if you suffer from heartburn after drinking water is this:
- Avoid drinking large amounts of water at once. It's better to slowly sip water than gulp it.
- Avoid drinking water right before, during, or right after meals. Drink it between meals when your stomach is empty.
- Drink room temperature or warm water instead of cold water. Cold water if you experience more severe pain, which is the result of esophageal spasms triggered by cold water. (If you just have normal heartburn pain, then the temperature of the water should not matter much)
You might also want to avoid other heartburn triggers, which drinking water will only complicate, so avoid:
- spicy foods
- alliums (garlic, onion, shallots, etc)
- acidic foods (tomatoes, orange juice, etc.)
- high-fat meals and meat (because they slow gastric emptying, or the time required for food to leave your stomach)
- clothing that is too tight around your waist
- lying down after eating