Acid Reflux and Heartburn with Dr Mohammed AlZaqam

Acid Reflux and Heartburn: Are Tea and Fried Foods to Blame?
Acid reflux—experienced as heartburn or a sour taste—occurs when stomach acid rises into the esophagus. Strong tea, coffee, fried foods, spicy dishes, carbonated drinks, and eating late at night are common triggers, though these vary from person to person.
Key recommendations include: eating smaller meals, losing excess weight, finishing your last meal 3–4 hours before bedtime, and elevating the head of your bed. Baking soda is not a long-term solution.

In Summary
Heartburn is the reflux of acid from the stomach into the esophagus; frequent occurrences may indicate gastroesophageal reflux disease (GERD) and require medical evaluation.
Strong tea, coffee, fried foods, spicy items, and carbonated drinks are common triggers—often found in Egyptian cuisine—but their impact varies by individual.
Avoid eating for 3–4 hours before sleep; evidence suggests that late-night meals increase nighttime acid levels.
Weight loss (if you are overweight) is one of the most effective lifestyle changes supported by evidence.
Elevate the head of your bed by 10–20 cm (rather than simply stacking pillows).
Baking soda is not a long-term remedy and increases sodium intake; consult a pharmacist or doctor.
Identify your personal triggers and try adjusting portion sizes or cooking methods before eliminating foods entirely.
Seek medical attention if you experience daily symptoms, difficulty swallowing, vomiting, or unexplained weight loss.
The short answer: Acid reflux—felt as heartburn or a sour taste—is caused by stomach acid rising into the esophagus. Strong tea, coffee, fried foods, spicy dishes, carbonated drinks, and eating late at night are common triggers, though they affect each person differently. Most importantly: eat smaller meals, lose excess weight, finish your last meal 3–4 hours before bedtime, and elevate the head of your bed. Baking soda is not a long-term solution.

"After work, I have some koshary with extra chili, a cup of strong tea, and then I go straight to bed... and by morning, I have a burning, stinging sensation in my chest!" This sentiment is frequently heard in clinics, especially among those who eat late or consume fried foods and carbonated drinks. This doesn't mean that Egyptian cuisine is inherently "harmful"; rather, it means that the timing, type, and portion size of your food play a significant role in acid reflux.

In this article, Dr. Mohamed El-Zaqam explains what clinical guidelines say about heartburn and acid reflux—using examples from Egyptian cuisine—without offering promises of a "cure" or prescribing specific medication dosages.

What are acid reflux and heartburn?
The NHS defines heartburn as a burning sensation in the middle of the chest, caused by stomach acid rising toward the throat (acid reflux). If this occurs frequently, it may be classified as gastroesophageal reflux disease (GORD/GERD).

Common symptoms, according to the NHS, include:

A burning sensation in the chest.
A sour or bitter taste in the mouth.
Occasionally, a persistent cough, hoarseness, bad breath, bloating, or nausea.
Symptoms often worsen after eating, or when lying down or bending over.

According to patient information from the American College of Gastroenterology (ACG), acid reflux is one of the most common digestive disorders, affecting approximately 20% of the U.S. population. Occasional heartburn after a heavy meal is common; however, pathological acid reflux is associated with frequent symptoms (occurring twice or more per week) or medically diagnosed damage to the esophagus.

Common Triggers: No Universal "Forbidden List"
The NHS recommends avoiding the specific foods and drinks that trigger symptoms for *you* personally.

Common triggers include coffee, tomatoes, alcohol, chocolate, and fatty or spicy foods. Educational materials from NHS hospitals (such as those at the University of Cambridge) also list tea or coffee (sometimes even decaffeinated versions), carbonated drinks, fried or fatty foods, spicy dishes, garlic, onions, peppermint, and vinegar.

Strong Tea and Coffee
A cup of strong tea after lunch, or coffee on an empty stomach, can increase heartburn for many people. You don’t necessarily have to give up tea entirely; try making it weaker, reducing your daily intake, or waiting a while after a meal before having a cup—then keep a log of your symptoms for two weeks.

Fried Foods (e.g., Fried Fava Beans and Falafel)
Fried and fatty foods are identified as triggers in NHS lifestyle guidelines. For instance, a serving of deep-fried falafel or fava beans sautéed in a large amount of oil—especially when eaten late at night—is harder on the stomach than fava beans prepared with a moderate amount of olive oil, or falafel that has been baked or oven-roasted.

Koshary with Chili and Hot Peppers
Spicy food is a common trigger. If the chili in your Koshary causes a burning sensation, try reducing the amount of chili or opting for a smaller portion—you don’t necessarily have to cut out Koshary altogether. Carbonated Drinks and Soda
Carbonated drinks are listed as potential triggers for acid reflux in the NHS dietary guidelines. The bubbles and the resulting expansion in the stomach can exacerbate the sensation of reflux in some people; try switching to water or a non-carbonated beverage and observe the difference.

Eating Late After Work
This is a common habit in Egypt that is strongly linked to nighttime heartburn: having a heavy meal immediately after work, followed by going to sleep. The NHS advises against eating within 3 to 4 hours of bedtime.

What Actually Helps? (Lifestyle Evidence)
1) Weight Loss (for those who are overweight)
The American Gastroenterological Association (AGA) recommends that patients with acid reflux who are overweight or obese should lose weight. Educational materials from the American College of Gastroenterology (ACG) indicate that weight loss can help improve symptoms.

A systematic review by Ness-Jensen et al. (2016) found that weight loss led to a reduction in the time the esophagus is exposed to acid—as shown in two randomized trials (decreasing from 5.6% to 3.7%, and from 8.0% to 5.5%)—and resulted in symptom improvement in observational studies. This suggests that even gradual weight loss—achieved through a balanced Egyptian diet and daily physical activity—is worth pursuing, ideally under medical supervision.

2) Meal Timing and the Last Meal Before Bed
The same review found, through randomized trials, that eating late at night increases the duration of esophageal acid exposure while lying down, compared to eating earlier in the day (a difference of approximately 5.2 percentage points). Practically speaking:

Eat smaller, more frequent meals instead of one large, heavy meal (an NHS recommendation).
Have a light dinner 3–4 hours before bedtime, if possible.
If you finish work late, opt for something like vegetable soup, yogurt, or a little low-fat cheese with bread, rather than a heavy meal (such as koshary) paired with a soft drink.

3) Elevate the head of the bed (do not just use extra pillows)
The NHS recommends raising the head of the bed by about 10–20 cm by placing blocks of wood or bricks under the bedposts at the head end, ensuring that the chest and head remain positioned higher than the waist. Do not rely on stacking extra pillows, as this can increase pressure on the abdomen and worsen symptoms.

In a small study included in a review by Ness-Jensen, elevating the head of the bed by approximately 10 inches reduced the duration of acid exposure in the esophagus while lying down (from 21% to 15%) compared to lying flat. Patient resources from the American College of Gastroenterology (ACG) also advise elevating the head of the bed.