Some chemotherapy drugs can cause heartburn. Here we explain what it is and what you can do to help.

What is heartburn?

Heartburn is also sometimes called indigestion or acid reflux. It is a burning feeling just behind your breastbone, in the centre of your chest. It can be mild but is sometimes very painful. It’s caused by acid from the stomach coming back up into your food pipe (oesophagus). The lining of the oesophagus is irritated by the acid and that’s what causes the burning and pain.  The irritation can also cause a sore throat, hoarse voice or a cough. You may also feel full up or bloated and have wind (burping).

Heartburn can make it difficult to eat, which can be a problem if chemo is already putting you off your food (because of nausea, taste changes or mouth problems). Usually it goes away once your treatment is over. If you are having radiotherapy to your chest as well as chemotherapy, you are more likely to have heartburn and it is more likely to last after your course of treatment is over.

What can bring on heartburn?

Chemotherapy drugs kill cells when they are multiplying, which affects some healthy cells as well as cancer. So they can cause heartburn because the cells that line the digestive system renew themselves often and are damaged and inflamed by the treatment. 

Although it is your chemotherapy that is making you more likely to have heartburn, there are quite a few things that help trigger it. Some foods are more likely to cause it, so it may help to keep a food diary and try to work out what sets it off in your case. There is a list of common foods that cause heartburn below.

Smoking and caffeine drinks may also make heartburn worse. Being overweight pushes the stomach contents upwards so that contributes, as does wearing tight clothing around your middle or lying down after eating.

Some medicines can cause heartburn, including over the counter painkillers such as aspirin or ibuprofen. Steroids are another cause and can be prescribed alongside chemotherapy.

Stress and anxiety can also sometimes cause heartburn. If you’re feeling stressed, it may help to try a relaxation technique, such as breathing exercises or mindfulness meditation.

What can help with heartburn?

Foods and drinks that can cause or make heartburn worse include:

  • Acidic foods – such as citrus fruits, tomatoes
  • Tea, coffee and soft drinks containing caffeine
  • Fizzy drinks
  • Alcohol
  • Spicy food
  • Fatty food – cream and other dairy products, fried foods, pastries and cakes
  • Foods that are very hot or very cold

During and after meals:

  • Loosen or avoid tight clothing and belts
  • It may help to sit at a table rather than on the sofa, as you’ll be more upright
  • Eat slowly and chew your food thoroughly – it will be more painful for large pieces of food to pass down an inflamed food pipe
  • Sip drinks and don’t fill yourself up with large amounts of fluids during meals
  • Don’t eat too much – frequent smaller meals or snacks are better than large meals
  • Don’t bend over or lie down for at least half an hour after eating

If you tend to get indigestion and heartburn at night, it may help to have the head of your bed (safely!) raised on blocks or sleep propped up on pillows. It’s also better not to eat for two to three hours before you go to bed.

Do tell your doctor if you’re having problems coping with heartburn. There are medicines you can take to help. It is best to speak to your doctor before you try any over the counter remedies so that they can rule out any other causes and recommend the medicine most likely to help. 

Anti-sickness medicines may also reduce heartburn. Being constipated may worsen symptoms (and can also be caused by some chemo drugs) so tell your doctor about that too.