Heartburn is common, and for many people it comes and goes without much trouble. But when heartburn doesn’t go away or keeps coming back, there’s usually more than one thing involved. Food choices, daily habits, medications, and digestive health can all play a part. Understanding what’s behind your symptoms can be a helpful first step toward feeling better.
What causes heartburn?
Heartburn occurs when stomach acid irritates the esophagus, the tube that carries food from the mouth to the stomach. While the stomach is built to handle strong acid, the esophagus is more sensitive and lacks the same protective lining. When acid reaches this sensitive tissue, it causes irritation that leads to a burning sensation.
For some people, this happens occasionally. For others, frequent or ongoing heartburn may be connected to acid reflux or gastroesophageal reflux disease (GERD), which often requires a more thoughtful, long-term approach to care.
Why won’t my heartburn go away?
If you’re wondering why your heartburn doesn’t seem to go away, there may be a few underlying reasons behind it:
Weakened lower esophageal sphincter
The lower esophageal sphincter (LES) is a ring of muscle that normally stays closed to prevent stomach contents from moving upward. When this muscle weakens or relaxes when it shouldn’t, stomach acid can more easily move into the esophagus. Over time, this dysfunction can lead to recurring heartburn, especially after meals or when lying down.
Diet triggers
The foods you eat can aggravate heartburn or GERD symptoms, which shows the role diet can play in managing the condition. Trigger foods vary from person to person, but eating more of your personal triggers — whether it’s spicy, fatty, citrus, carbonated beverages, tomato-based foods, chocolate, or something else — can worsen reflux.
Delayed stomach emptying
Research suggests that delayed stomach emptying isn’t usually the main cause of GERD, but it can make symptoms worse for some people. This helps explain why diet, portion size, and meal timing can influence how often or how strongly symptoms occur.
Lifestyle factors
Lifestyle factors also play a role in heartburn. Excess weight, sedentary habits, smoking, alcohol intake, wearing tight clothing, or lying down too soon after meals can all increase reflux. Paying attention to these habits and making small adjustments can help reduce symptoms and provide relief.
Reduced saliva production
Saliva plays an important role in protecting the esophagus. This complex mix of water, electrolytes, proteins, enzymes, and buffering agents helps neutralize stomach acid and wash it back into the stomach.
Conditions that reduce saliva — such as dehydration, certain medications, or age-related changes — can leave the esophagus more vulnerable to acid exposure. This can contribute to acid reflux that lasts for days, making heartburn feel more intense or harder to manage.
Hiatal hernia
A hiatal hernia occurs when part of the stomach moves upward through the diaphragm, weakening the natural barrier that normally helps keep stomach acid in place. When this support is disrupted, acid can more easily flow back into the esophagus, increasing the likelihood of ongoing heartburn and reflux.
Because the anatomy is altered, reflux can be harder to control, and symptoms may linger rather than resolve quickly. This helps explain why heartburn linked to a hiatal hernia can last for several days, even without obvious triggers.
Other conditions
In some cases, heartburn that doesn’t go away easily may be influenced by other underlying conditions affecting the esophagus or stomach, including inflammation, structural changes, or, more rarely, serious conditions such as esophageal cancer.
How to manage heartburn that doesn’t go away
When heartburn persists, treatment usually falls into two main approaches: medication and lifestyle changes. Medications can help control symptoms, while daily habits play a key role in reducing triggers and preventing flare-ups. Often, the most effective relief comes from using both together.
Medications
Over-the-counter options like antacids, H2 blockers, and proton pump inhibitors work in different ways to reduce or neutralize stomach acid, offering anything from quick, short-term relief to longer-lasting symptom control and esophageal healing. In more persistent cases, prescription versions of these medications may be recommended, particularly when symptoms don’t respond to OTC treatments or when there is evidence of irritation or damage.
That said, medications are not an instant fix or a long-term solution on their own. Some work quickly but wear off fast, while others require consistent use over several days to be effective. Even when medication helps control symptoms, lasting improvement typically depends on addressing the underlying drivers of heartburn.
Adjust meal timing and eating habits
Eating smaller, more frequent meals can reduce pressure on the stomach and help prevent acid from flowing upward. Taking your time with meals — chewing thoroughly, eating slowly, and stopping before you feel overly full — can also support digestion and help prevent reflux. Paying attention to hunger and fullness cues can make these eating habits easier to maintain over time.
Maintain a healthy weight
Reducing excess pressure on the stomach by supporting a healthy weight can help lower the risk of acid reflux and ease persistent heartburn. Small, gradual changes over time — like incorporating regular physical activity, moving more throughout the day, and balancing meals — can make symptoms easier to manage.
Drink more fluids
Staying hydrated helps digestion and can dilute stomach acid, reducing irritation in the esophagus. Opt for warm drinks like water or herbal teas, which are gentler on the stomach, and avoid carbonated beverages, coffee, chocolate, or acidic juices that may trigger reflux.
Reduce stress
Stress doesn’t directly cause heartburn, but it can make it worse by increasing stomach acid, heightening pain sensitivity, and triggering behaviors (like overeating or poor sleep) that aggravate acid reflux. Practices such as deep breathing, meditation, yoga, or regular exercise can help manage stress and improve digestion.
Identify trigger foods and drinks
Certain foods and drinks are more likely to cause heartburn. When personal triggers aren’t identified, they may contribute to heartburn that doesn’t go away. Common culprits include spicy foods, fatty or fried meals, citrus, tomato-based products, chocolate, caffeine, and alcohol. Paying attention to patterns and making small, manageable changes can help ease symptoms over time.
Build a reflux-friendly diet
Eating the right foods can help reduce reflux symptoms and make daily meals more comfortable. Aim for balanced meals built around gentle, easy-to-digest foods that support comfort and consistency, such as:
- Lean proteins: chicken, turkey, fish, eggs, tofu, legumes
- Low-acid fruits and vegetables: bananas, melons, apples, pears, berries, leafy greens, zucchini, carrots
- Low-fat dairy or alternatives: skim milk, yogurt, kefir, almond or oat milk
- Whole grains: oatmeal, brown rice, quinoa, whole wheat bread
- Herbs and mild seasonings: ginger, turmeric, cinnamon, rosemary, basil, parsley, thyme
Rather than choosing foods in isolation, think about how they come together across the day. Spreading meals evenly, pairing protein with fiber, and keeping portions comfortable can all be part of a sustainable reflux diet plan. If symptoms continue, a registered dietitian can help you create a personalized diet plan that supports both symptom relief and balanced nutrition.
When to seek medical help for persistent heartburn
If heartburn doesn’t go away despite using medications or making lifestyle changes, it may be time to consult a healthcare provider.
They may suggest testing to better understand what’s causing your symptoms and guide next steps. Getting support sooner can make heartburn easier to manage and help protect the esophagus over time.
Get one-on-one guidance from a registered GERD dietitian
Heartburn won’t always go away on its own, often because multiple factors contribute to it. Finding lasting relief usually starts with understanding what’s driving your heartburn, rather than only trying to manage it when it flares up.
Because diet and lifestyle play a meaningful role for many people, small, thoughtful adjustments to meals, routines, and habits can make a difference. A registered GERD dietitian can help you identify triggers, create a personalized nutrition plan, and develop practical lifestyle strategies that feel realistic and sustainable.
If you’ve been dealing with symptoms for a while, you don’t have to manage them on your own. A Health Loft dietitian can offer personalized guidance to help you feel more supported as you work toward relief. When you’re ready, book a session to explore next steps together.
Frequently asked questions about heartburn
Why doesn’t heartburn go away, even when I take antacids?
Antacids provide quick, over-the-counter relief by neutralizing acid in the stomach or esophagus. Made from calcium, magnesium, or aluminum compounds, they ease symptoms fast — but they don’t prevent more acid from forming or refluxing.
What can happen if I ignore heartburn?
Ignoring ongoing heartburn can lead to several problems over time. Acid can wear down tooth enamel, irritate the vocal cords, and leave a sour or bitter taste in the mouth. It can also cause esophageal ulcers, esophageal narrowing, worsen symptoms of asthma, or more serious changes that increase the risk of complications. Getting care early can help prevent these issues.
This article was reviewed by Katie Whitson, RD, LD. It is intended for informational purposes only and does not replace personalized nutritional advice.
