If you have heard that the major causes of heartburn are related to food, it may seem confusing that heartburn on an empty stomach is possible. The truth is, heartburn is usually triggered by food – but that’s not the cause of the painful burning you feel when you get heartburn.
The cause of heartburn is acid reflux, and acid reflux can occur at any time – even when there is no food in the stomach. It is a condition in which the naturally occurring liquids in the stomach make their way into the oesophagus. Since the muscle that protects us from that process is usually closed, these acids tend to remain in the stomach.
However, this muscle (known as the lower oesophagal sphincter or LES) is known to relax after eating certain types of food and randomly throughout the day, leaving the oesophagus open to acids. In people with certain gastric conditions, the LES may be permanently weakened, which makes it much easier for heartburn to happen – especially heartburn on an empty stomach.
The reason that heartburn triggered by food is more discussed than heartburn on an empty stomach is that food is the most common trigger in most people. As you might expect, controlling the types of food we eat and how much of it we consume can do much to help prevent heartburn.
The LES can be forced open when we have overeaten food, and particular food causes the over-production of acids which also weaken the LES by pressurizing the stomach (gas). If you have ever burped and regurgitated a sour tasting, acidic substance, you have felt the effects of this type of gas pressure first hand.
Heartburn on an empty stomach isn’t much different, except that food isn’t the trigger; a lack of food is the trigger. In simple terms, when stomach acid has nothing to “do” it can become concentrated. Some people report that heartburn on an empty stomach is worse than the heartburn they feel when they’ve eaten an offending food because the acid is very concentrated on an empty stomach.
Do I Need to See a Doctor for Heartburn on an Empty Stomach?
Most people will experience heartburn on an empty stomach at some time in their lives. It can easily occur when we drink something acidic such as orange juice, or when consuming a caffeinated or carbonated beverage without first having eaten a meal.
One should also consider seeing a physician if sudden, extremely painful or persistent heartburn is occurring because this may be a sign of something more serious than a stomach acid problem. Heartburn is uncomfortable, but debilitating pain is a symptom for which you should get help. Even if it’s “just heartburn”, continuous exposure to stomach acid can significantly damage the oesophagus.
Most heartburn can be controlled with dietary and lifestyle changes. Still, if you get heartburn on an empty stomach only once in a while, the treatment is relatively straightforward: eat something that isn’t going to upset your stomach. Eating should help if your stomach is empty, and you know you aren’t suffering from another condition that causes heartburn.
Some people frequently get heartburn on an empty stomach and should consider getting a medical opinion about their symptoms. Commonly, a person who gets heartburn on an empty stomach a couple of times a week or more is experiencing the symptoms of a widely occurring disease known as GERD.
How GERD Causes Heartburn on an Empty Stomach
GERD stands for “gastroesophageal reflux disease”, a condition in which a person’s stomach is continually producing more acid than it should. The acid is always there, waiting to get into the oesophagus and cause a person to feel the symptoms of heartburn.
Unfortunately, people with GERD tend also to have a more relaxed LES. Since the muscle isn’t working to block acid, it can quickly rise and cause heartburn on an empty stomach.
Is GERD the only Cause of Heartburn on an Empty Stomach?
GERD is not the only cause of heartburn on an empty stomach. Another condition that may cause symptoms that feel like those associated with GERD is a peptic ulcer. Peptic ulcers are small holes in the protective lining inside the stomach and are caused by the acids themselves.
The H pylori bacterium is the most common link in people with peptic ulcers. Medical experts believe this to be the reason that the stomach lining becomes vulnerable to the effects of acids.
As acid continues to wash over these small holes, they become agitated. On an empty stomach, when the acids have “nothing to do” as mentioned earlier, the ulcers can be quite painful. Most people feel this pain in the stomach, but some report heartburn like symptoms as well.
In either case (GERD or Peptic Ulcer), they are eating smaller, more frequent meals and other heartburn remedies can help to curb the feeling of heartburn on an empty stomach.