1. Eating Pattern. Anyone who eats a heavy meal and subsequently lies on the back or bends over from the waist is at risk for an attack of heartburn. Anyone who snacks at bedtime is at high risk for heartburn.
2. Pregnancy. Pregnant women are particularly vulnerable to heartburn in their third trimester as the growing uterus puts increasing pressure on the stomach. Heartburn in such cases is often resistant to dietary interventions and even antacids.
3. Obesity. A number of studies suggest that obesity contributes to acid reflux and may increase the risk for erosive esophagitis in acid reflux and heartburn patients.
4. Respiratory Diseases. People with asthma are at very high risk for acid reflux and heartburn. One study indicated that patients with chronic obstructive pulmonary diseases (e.g., emphysema or chronic bronchitis) were more likely to have acid reflux and heartburn.
5. Smoking. Increasing evidence indicates that smoking increases the risk for acid reflux and heartburn. Studies suggest that smoking reduces LES muscle function, increases acid secretion, impairs muscle reflexes in the throat, and damages protective mucus membranes. Smoking reduces salivation, which helps neutralize acid. Whether it is the smoke, nicotine, or both that triggers acid reflux and heartburn is unknown. Some people who use nicotine patches to quit smoking, for example, experience heartburn, but it is not clear if it's the nicotine or stress that produces acid back-up.
6. Alcohol Use. Alcohol has mixed effects on acid reflux and heartburn. It relaxes the LES muscles and, in high amounts, may irritate the mucous membrane of the esophagus. All alcoholic beverages increase stomach acid levels. A combination of heavy alcohol use and smoking even increases the risk for esophageal cancer.
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