Why Water Might Be Causing Your Heartburn: The Science Behind ItPublished on Tuesday, September 19, 2023 by
The Science of Water and GERD: Understanding the Connection
Put down your water bottle; you’ve got to read this.
Drinking more water is always mentioned as one of the best things we can do for our bodies and health. And nobody denies that good old H2O is the way to go when looking for healthy hydration options. As a dietitian, I’ve coached numerous people into drinking more water.
But then, this summer, I noticed something about my own water drinking. It was having an unwanted impact on my body—specifically, it was giving me heartburn. This happened mostly at night but also during the day sometimes. This baffled me as I’d never heard of drinking water leading to heartburn. Let’s dive into what the science says about a link between water drinking and GERD.
Water and digestion
When you eat, hydrochloric acid is released into your stomach to help the food break down. This creates an acidic liquid that can sometimes back up into the esophagus and cause GERD symptoms. Food digestion can take several hours to a day or longer, depending on the composition of the food and individual factors. However, the water we drink is typically absorbed quickly since the body doesn’t have to do much for it to be absorbed. In fact, when there is no food in the stomach, any water consumed can be absorbed in as little as 5 minutes.
On the other hand, when food is also present or consumed along with the water, such as when we drink water with a meal, it takes longer to absorb the water. For example, other liquids, such as juice or milk, will take longer to digest than plain water because of their different components. Nevertheless, drinks are still more quickly handled than solid food.
Does water cause reflux symptoms?
Drinking plain water does not cause heartburn or other GERD symptoms for most people. In fact, swapping water for coffee, tea, or soda (beverages typically associated with acid reflux) is an effective way for some folks to reduce their symptoms. There is even an indication that drinking alkaline water may help reduce hydrochloric acid’s effects on the body, leading to improvements in acid reflux, although more research on that is needed.
Carbonated water, like seltzer, can contribute to reflux symptoms for some people. Drinking plain water does briefly decrease the acidity of the stomach contents, but there’s no scientific evidence that this improves GERD or acid reflux.
So why was I experiencing heartburn after drinking water? It turns out that it might have something to do with my water-drinking habits…
Water and stomach distension
You’re probably familiar with the fact that eating large meals, especially at night, can trigger reflux symptoms. And although you might have trigger foods, sometimes it’s not just what you’re eating, but how much. Eating a big meal or having a full stomach in general leads to gastric distension and a bloated feeling. And it’s not just food that causes stomach distension; water does it, too.
Research shows that gastric distension increases the exposure of the lower esophageal sphincter to acidic stomach contents—not to mention forcing the acidic gastric juices to come back up into the esophagus. Some studies have shown that people with frequent heartburn, bloating, and acid reflux (sometimes called functional dyspepsia) aren’t able to drink as much water as people without these issues.
What’s more, these folks become bloated, and experience increased abdominal pressure and feelings of fullness earlier than others. Sound familiar to you? It does to me. As good as water is for you, it’s apparent that drinking a lot of water at once will make the distension worse. The same goes for drinking water during a meal.
How to handle your water if it causes you symptoms
Nobody would suggest that people with GERD or reflux stop drinking water. It’s the ideal beverage for bodily health. So what can be done? I’ve learned a few things that have helped me, including:
- Space your water drinking throughout the day. I found that most of the time, I drank water mainly in the morning and then again at night. I hadn’t realized that I was skimping on the water during the larger part of the day; hence, I was pretty thirsty come dinnertime. My lesson: don’t wait until the evening to compensate for not drinking enough water during the day.
- Sip water instead of guzzling it. Having sips of water regularly versus downing an entire bottle or big glass at once helps you hydrate without creating stomach discomfort.
- Experiment with cutting back on beverages during meals and consuming most of your liquids between meals. Minimizing drinks during meals can help prevent them from taking up too much volume in the stomach. Keeping mealtime beverages in check also will allow for better nourishment because you’ll be more likely to finish your meal.
- Keep in mind that seltzer or other carbonated beverages can trigger symptoms, so avoid them if necessary.
- Péronnet, F., Mignault, D., du Souich, P., Vergne, S., Le Bellego, L., Jimenez, L., & Rabasa-Lhoret, R. (2012). Pharmacokinetic analysis of absorption, distribution and disappearance of ingested water labeled with D₂O in humans. European journal of applied physiology, 112(6), 2213–2222. https://doi.org/10.1007/s00421-011-2194-7
- Mehta, R. S., Song, M., Staller, K., & Chan, A. T. (2020). Association Between Beverage Intake and Incidence of Gastroesophageal Reflux Symptoms. Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 18(10), 2226–2233.e4. https://doi.org/10.1016/j.cgh.2019.11.040
- Koufman, J. A., & Johnston, N. (2012). Potential benefits of pH 8.8 alkaline drinking water as an adjunct in the treatment of reflux disease. The Annals of otology, rhinology, and laryngology, 121(7), 431–434. https://doi.org/10.1177/000348941212100702
- Karamanolis, G., Theofanidou, I., Yiasemidou, M., Giannoulis, E., Triantafyllou, K., & Ladas, S. D. (2008). A glass of water immediately increases gastric pH in healthy subjects. Digestive diseases and sciences, 53(12), 3128–3132. https://doi.org/10.1007/s10620-008-0301-3
- Ayazi, S., Tamhankar, A., DeMeester, S. R., Zehetner, J., Wu, C., Lipham, J. C., Hagen, J. A., & DeMeester, T. R. (2010). The impact of gastric distension on the lower esophageal sphincter and its exposure to acid gastric juice. Annals of surgery, 252(1), 57–62. https://doi.org/10.1097/SLA.0b013e3181e3e411
- van den Elzen, B. D., Bennink, R. J., Holman, R., Tytgat, G. N., & Boeckxstaens, G. E. (2007). Impaired drinking capacity in patients with functional dyspepsia: intragastric distribution and distal stomach volume. Neurogastroenterology and motility, 19(12), 968–976. https://doi.org/10.1111/j.1365-2982.2007.00971.x
- National Institute of Diabetes and Digestive and Kidney Disease (2016, November). Definition and Facts of Indigestion. National Institutes of Health. Retrieved Aug 22, 2023 from https://www.niddk.nih.gov/health-information/digestive-diseases/indigestion-dyspepsia/definition-facts
Kitty BroihierMS, RD, LD