Does pizza cause heartburn?

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Many people experience stabbing chest pain after eating pizza, and for a good reason. Pizza usually contains a lot of fat, sugar, and tomato, all of which are common heartburn triggers.

Why does pizza give you heartburn?

Pizza with tomatoes

Pizza is the perfect storm of ingredients that cause heartburn. There are layers of crust, sauces, meat, and cheese, all of which are common triggers of heartburn for those, who suffer from acid reflux.

On top of that, the toppings usually contain a lot of tomato sauce, which is one of the few vegetables (e.g. onion) that are known to cause reflux symptoms.

But it’s not only the ingredients that can make your chest burn:

  • Overeating: It is very easy to eat too much pizza. A full stomach further increases the risk of an acid reflux episode.
  • Eating too fast: Quickly grabbing a few slices of pizzas and eating them fast, without properly chewing them is another risk factor for heartburn.
  • Mind what you drink: A large can of cold soda, full of sugar and bubbles can trigger heartburn by itself.

This study examined 126 people with GERD or possible GERD and found that pizza was one of the frequent trigger foods.

How to eat pizza with acid reflux?

Choosing the right ingredients, chewing the pizza well, eating it slowly and in moderate amounts decreases the chance of experiencing heartburn or other acid reflux symptoms.

Avoid tomato or barbecue sauce


Barbecue sauce or tomato-based sauce is used to create the iconic red sauce for your pizza. They are all acidic items that may aggravate acid reflux. WebMD lists tomato as one of the top 10 heartburn triggers.

Try other sauces for your pizza, that aren’t tomato-based. You may use a fat-free white cream sauce or olive oil-based sauce.

Choose low-fat cheese

Pizza with cheese

Pizza is often made with fatty cheese. As fat might induce acid reflux episodes, those who are prone to heartburn should steer clear of it and go for a low-fat or fat-free alternative.

You may choose from a range of different cheeses, including fat-free cheese, or you can go for low-fat cheese, e.g. cheese made of goat milk.

Choose lean meats, avoid red meat


Lean meats such as chicken, turkey, or tuna are low in fat, easier to digest, and are therefore less likely to trigger acid reflux.

Avoid hard-to-digest, fatty red meat, like beef, pork, sausages, and pepperoni as they are more likely to trigger symptoms. (Albeit, poultry also increases the risk of GERD symptoms.)

Choose thin-crust pizza

The crust contains a lot of carbohydrates that are hard to digest.

Diet high in carbs has been linked to more frequent reflux symptoms. While this study found that a very low-carbohydrate diet improves symptoms.

A thin crust or using whole grain flour can reduce the chance of getting heartburn after eating pizza.

Mind the toppings

Avoid toppings that are frequent triggers:

  • pineapple
  • jalapenos
  • onion
  • spice

Several fruits and vegetables might bring on chest pain, but the exact trigger foods are often different for different people.

If you are prone to heartburn, know your trigger foods and don’t use them as toppings on a pizza.

Is vegan pizza good for heartburn?

By choosing a vegan pizza you eliminate two risk factors: meat and cheese. Both contain fat, so if fat triggers symptoms for you, vegan pizza might be a good choice.

However, there are still a few ingredients you should be mindful of. The most important is tomato. A pizza might contain a lot of tomatoes which can trigger heartburn.

Other fruits and vegetables that often cause symptoms are:

  • onion
  • garlic
  • pineapples
  • jalapenos

Some people are prone to have symptoms after eating spicy foods, so be easy on the spices when making the topping for the pizza.

Best pizza for acid reflux

By “best” we mean a pizza that is least likely to trigger heartburn and other reflux symptoms.

A few tips on how to make such pizza:

  • thin crust from whole grain flour
  • white cream, olive oil instead of tomato sauce
  • low-fat or fat-free cheese
  • no red meat, use chicken or tuna instead, or no meat at all
  • use heartburn-friendly vegetables for toppings (e.g. spinach, carrot, broccoli)

However, with the wrong eating habits, even the best pizza might not save you from heartburn:

Another thing to consider is that homemade pizza is usually better for heartburn sufferers, as it contains a lot less sugar, salt, and preservatives than the ones sold in supermarkets.

Other health issues pizza can cause

Heartburn is not the only symptom a pizza can trigger. Coughing, a sore throat, and stomach pain are probably the most common issues people experience after eating a pizza.

Sometimes symptoms are triggered by the ingredients, at other times the eating habits cause problems.

Coughing and sore throat after eating pizza

Coughing and sore throat might be symptoms of acid reflux. In this case, stomach acids seep up to the throat, causing there irritation and making you cough, sometimes producing excessive amounts of phlegm.

Another possible reason is a food allergy. Those who are allergic to any ingredient of the pizza might experience mild symptoms, like rashes, hives, or itchy eyes.

More severe allergy symptoms are:

  • breathing problems
  • swollen throat, lips, or tongue
  • anaphylaxis, which requires immediate help

Stomach pain and pizza

Pizza, especially if it contains a lot of fat, might also trigger stomach problems.

Fat is very hard to digest and an underlying medical issue in the digestive tract can easily trigger symptoms:

  • Upset stomach: Simply eating too much can be enough to cause stomach pain. This is probably the most common cause, symptoms should go away after some time.
  • Gallbladder issues: Fatty foods often trigger symptoms for those who have gallstones or an inflamed gallbladder. A typical symptom is pain in the right side of the body, e.g. shoulder, arm, neck.
  • Pancreatitis: An inflamed pancreas might also be the culprit of experiencing stomach pain after pizza. In this case, symptoms are more likely to occur on the left side of the body.

Final thoughts

Pizza contains many ingredients that are known heartburn risk factors. Fat, carbs, and tomato are the most common ones.

Some other risk factors are indirectly associated with eating pizza: eating too much or too fast or drinking soda might also trigger heartburn.

If you are prone to acid reflux, you might want to try a heartburn-friendly pizza, that contains lean meat, low-fat cheese, no tomatoes.