Heartburn when hungry or fasting

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Just like overeating, not eating enough might also trigger heartburn and other acid reflux symptoms.

People prone to reflux should talk to their doctors before starting fasting as it might aggravate symptoms.

Benefits of fasting

Fasting is simply not eating (and sometimes drinking) for a duration of time for religious, ethical, health, or ritualistic reasons.

Fasting for religious purposes is a very old practice that dates to ancient times.

Fasting for therapeutic reasons came to light in the 5th century BCE, when the most famous Greek physician Hippocrates, recommended abstinence from food or drink for patients that had certain types of disease symptoms.

Today, the quest to stay healthy and fit has made intermittent fasting very popular as it has been demonstrated to help people lose weight, meet their fitness goals, and stay healthy.

Whatever be the reason for fasting, the length of time tends to vary, some people fast for a couple of hours a day, some others fast for 24 hours, some choose certain days of the week to fast, and some go days and weeks straight without food (this is popular with religious fasting).

Why do I get heartburn when I haven’t eaten?

Some people experience acid reflux symptoms, like heartburn, while fasting.

The stomach produces gastric acid which mixes up with food to digest the food when we eat. However, even when we do not eat, our stomach still produces gastric acid, though in a limited amount.

So, when there is no food to be digested, this acidity of the stomach is higher, as such gastric acid can seep backward into the esophagus and cause heartburn.

Typically, it takes an average of 3 hours for the stomach to empty its content into the small intestines. Gastric emptying research studies report a range of 2-5 hours for food to completely leave the stomach depending on the type of food (fats and high-calorie foods delay gastric emptying).

So prolonged periods of not eating anything long after the previously eaten food has been emptied can trigger acid reflux and heartburn in certain people, especially those who are suffering from acid reflux.

Besides, smelling food and thinking of food can trick the brain into thinking you want to eat and thus stimulate the secretion of gastric juices, which can trigger acid reflux on an empty stomach. Therefore, sensitive people are advised not to skip meals or go on fasting.

Can not drinking enough cause heartburn?

Some people abstain not only from food but also from drinking while fasting.

Not drinking enough fluids like water, has been shown to cause acid reflux and consequently heartburn. Water has a neutral pH of 7, hence it neutralizes stomach acid, temporarily raising the pH of the stomach, which may help to decrease the occurrence of acid reflux.

Besides, water increases bowel motility, which is crucial for preventing the backflow of stomach contents into the esophagus causing heartburn.

Gastrointestinal problems like acid reflux, gastritis, and constipation, have been described by health experts as indicators of chronic dehydration.

Can intermittent fasting cause acid reflux?

Empty plate

Intermittent fasting is fasting for specific amounts of time. Popular types are the 12hour, 14hour, 16hour, 24 hours, 5:2 method (fasting for two non-consecutive days a week), alternate day, and warrior’s diet fasting.

There exist mixed opinions as to whether intermittent fasting causes acid reflux or not.

While some studies have reported that intermittent fasting helps people not overeat and thus control their acid reflux episodes, others have attested that it worsens acid reflux symptoms.

This is because fasting offsets the balance of acids in the stomach, as there is no food to soak up the acid secreted in the stomach over time. Consequently, the stomach acid secreted piles up, increasing the chances of acid reflux occurrences.

Besides, fasting has been proven to slow down gastric emptying by stimulating certain hormones, and slower gastric emptying increases the frequency and duration of acid reflux.

So, depending on the severity of one’s acid reflux situation, they may have different experiences with intermittent fasting.

But experts generally advise people with reflux to stay away from any type of intermittent fasting or do so with much caution, as it is more likely to cause acid reflux than help.

What causes painful swallowing after fasting?

Painful swallowing

Chest pain when swallowing – called odynophagia – might be experienced when eating food or drinking. It might be temporary and can resolve on its own or be more permanent and recurrent due to an underlying health condition or sicknesses like cancer or Candida infection of the mouth.

Some people experience pain when swallowing after fasting. Research studies are lacking to properly explain why this happens, though people associate it woth acid that may have refluxed way up to the throat due to prolonged periods of not eating.

Since the digestive tract has been inactive for a long time due to fasting, it’s only normal to awaken it slowly by consuming something light and drinking plenty of water, else the sudden introduction of food may strain its muscles a little, causing pain that may be experienced by some after fasting.

People after fasting tend to eat too fast and don’t chew properly when they break a fast due to hunger created by the long fasting period, which can cause painful swallowing.

Furthermore, swallowing problems are common symptoms for GERD patients, so if such people are fasting, they are most likely to encounter this also.

For this reason, people are advised to break their fast with water and meals that are lighter and softer, to prevent any swallowing difficulty.

Mucus in the throat while fasting

Mucus is produced in the body to help trap microbes and prevent their spread throughout the body, which makes us sick.

There is no information now that supports that fasting causes mucus in the throat. On the contrary, fasting has been reported to boost the immune system by limiting inflammation and promoting cell regeneration.

Though studies accessing mucus in the throat while fasting are lacking, some people have reported a clearing of sinuses (which is known to cause mucus in the throat as well) with fasting.

Final thoughts

Fasting is a common practice that is performed for different reasons these days. While fasting has been proven to have numerous health benefits, it may cause acid reflux and aggravate heartburn symptoms in some people (sensitive and non-sensitive people). Experts advise that people should proceed with fasting with much caution to monitor and watch out for heartburn symptoms.

This article has been written by:

Meggy Jones

Expert Nutritionist and Food Scientist,
M.Sc. – Nutrition, ugent, Belgium