Medications That May Cause Heartburn

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While we most often think of certain foods as causing heartburn, there are also some medications that may cause heartburn. This is a result of relaxing the lower esophageal sphincter (LES), irritating the esophagus, or slowing stomach-emptying.

Below are some of the medications that may cause heartburn. Each individual is different, so it's important to remember that while some medications trigger heartburn for some people, it may not be the case for you.

If you do suspect that one of your medications is worsening your heartburn, it is important to talk to your primary healthcare provider. You should not stop taking your medication unless advised to do so by your doctor. While it may stop the heartburn, the consequences of suddenly stopping some medications can be worse than the heartburn.

Medications that may cause heartburn include:

  • NSAIDs (nonsteroidal anti-inflammatory drugs) (e.g. ibuprofen and naproxen)
  • Nitrates and nitroglycerin
  • Progestin (e.g. for abnormal menstrual bleeding or birth control)
  • Sedatives for insomnia or anxiety
  • Some narcotics (e.g. Meperidine {Demerol} )
  • Some steroid medications
  • Tricyclic antidepressants, which include Tofranil (imipramine), Sinequan (doxepin), Norpramin (desipramine), Pamelor (nortriptyline)
  • Potassium
  • Iron supplements
  • Theophylline
  • Vitamin C


Other Causes of Heartburn

Heartburn can be due to various conditions, including abnormal biologic or structural factors. It is important that individuals who suffer from frequent heartburn consult with their physicians to find the cause of their acid reflux, and agree on a treatment plan.

Malfunction of the Lower Esophageal Sphincter (LES) Muscles
The band of muscle located at the junction between the esophagus and the stomach is called the lower esophageal sphincter (LES). This muscle is responsible for closing and opening the lower end of the esophagus and acts as a pressure barrier against the contents in the stomach. If it is weak or loses tone, the LES will not close completely after food passes into the stomach. Stomach acid can then back up into the esophagus. Certain foods and beverages, drugs, and nervous system factors can weaken LES and impair its function.

Impaired Stomach Function
One study has shown that over half of GERD patients showed abnormal nerve or muscle function in their stomachs.

These abnormalities cause impaired motility. This occurs when the muscles in the stomach cannot act spontaneously. The muscles do not contract normally, which causes delays in the stomach's ability to empty. This can increase pressure in the stomach which, in turn, can increase the risk for stomach acid to back up into the esophagus.

Motility Abnormalities.
In normal digestion, food is moved through the digestive tract by rhythmic contractions called peristalsis. When someone suffers from a digestive motility abnormality, these contractions are abnormal. This abnormality can be due to one of two causes: A problem within the muscle itself, or a problem with the nerves or hormones that control the muscle's contractions. Problems in peristalsis in the esophagus are common in GERD, although it is this not clear if such occurrences are a cause or result of the long-term effects of GERD.

Hiatal Hernia
A hiatal hernia occurs when the upper part of the stomach pushes through an opening in the diaphragm, and up into the chest. This opening is called the esophageal hiatus or diaphragmatic hiatus. It is believed that a hiatal hernia can weaken the (LES) and cause reflux. However, studies have failed to prove that it is a common cause of GERD. A hiatal hernia, however, may increase GERD symptoms in patients with both conditions.

Genetic Factors
Studies have suggested there is an inherited risk in many of the cases of GERD. This could be because of of inherited muscular or structural problems in esophagus or stomach. Genetic factors may also be an important aspect in a patient's susceptibility to Barrett's esophagus, a precancerous condition caused by very severe gastroesophageal reflux.



Mayo Foundation for Medical Education and Research - John E King, M.D., Editor in Chief, First. Mayo Clinic on Digestive Health. Kensington Publishing, 2000. 70. Print.

Steven R. Peikin, M.D., First. Gastrointestinal Health. First Edition. Harper Perennial (Harper Collins Publishers), 1999. 40. Print.

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