ZocdocAnswersWhy do I have severe heartburn when I eat tomatoes late at night?

Question

Why do I have severe heartburn when I eat tomatoes late at night?

I am a 30 year old woman that was previously diagnosed with acid reflux. The condition went into submission a few years ago; however, ever since I gave birth to my son I have been experiencing the worst heartburn!

Answer

Acid reflux or heartburn--otherwise known as GERD, or gastroesophageal reflux disease--can be a very painful and disruptive problem. It is also quite common, affecting a large number of adults and often becoming particularly problematic in pregnant women or those who have had children. Talking with your primary care physician is the place to start with your heartburn symptoms. Depending on how well you respond to lifestyle management options and available medications, he or she may refer you to a gastroenterology specialist. Heartburn occurs when the acid secretions of the stomach (important for helping us digest food) inappropriately 'back-up' into the esophagus. The stomach has a specialized lining to help protect it from the acid gastric secretions, but since the esophagus was not designed to produce acid, it lacks these protective mechanisms. As a result, acid gastric fluid in the esophagus can be very burning and painful. In some people, the transition between the stomach and the esophagus--called the esophageal sphincter--is loose enough to make it very easy for fluid from the stomach to go backwards into the esophagus. Unfortunately, many of the hormones produced during pregnancy can exacerbate this. Treating heartburn rests on trying to minimize production of stomach acid and using gravity to keep food from refluxing. For this reason, your doctor will likely recommend that you avoid acidic, spicy, or caffeinated foods. You should also avoid eating late at night before you go to bed, as this can promote food moving up into the esophagus when you lay down. There are also several medications available that can help minimize the amount of acid your stomach produces to help control symptoms.

This answer is for general informational purposes only and is not a substitute for professional medical advice.

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