Are Heartburn And Constipation Related? The Strange Connection Explained

You've likely experienced the telltale symptoms of heartburn at some point: a burning sensation in the center of your chest, often accompanied by a bitter, acidic taste. Heartburn occurs when the sphincter muscle at the bottom of the esophagus, the tube leading from your mouth to your stomach, opens at the wrong time, allowing stomach acid to travel up into the esophagus. Heartburn can flare up after eating, in the evening, or when lying down or bending over. It's usually not serious, and most people manage occasional episodes with over-the-counter medications or lifestyle changes, such as avoiding fatty or spicy foods, caffeine, or alcohol.

Interestingly, people who are prone to having frequent bouts of heartburn, a condition known as gastroesophageal reflux disease (GERD), may also often find themselves struggling with irregularity. For example, a 2022 study published in the Journal of Neurogastroenterology and Motility found that GERD was associated with a 56% to 144% greater probability of having constipation, depending on how it was diagnosed. According to experts, there are a couple of possible explanations that would account for this connection.

There are several common medications that can cause constipation as a side effect, including some popular heartburn treatments. And, this is especially true if you have GERD or must use them frequently. For example, Tampa Bay Reflux Center notes that antacids containing aluminum, such as Maalox, Mylanta, and Gaviscon, can lead to constipation because the aluminum reduces the rate of contractions in the stomach and intestines. 

According to Healthline, proton pump inhibitors like Prilosec, Nexium, and Prevacid can also cause digestive side effects, including constipation.  The authors of a 2005 study published in Alimentary Pharmacology and Therapeutics note that these medications can cause delayed gastric emptying, which may contribute to this condition.

Cleveland Clinic adds that H2 blockers like Tagamet, Axid, and Pepcid have a low risk of side effects. However, if you do have side effects, constipation may be one of them.

Another possibility is that both conditions arise from a motility disorder, Suneeta Krishnareddy, M.D., a gastroenterologist, internist, and associate professor of digestive and liver diseases at Columbia University Irving Medical Center, told Health Central. A motility disorder slows down the gastrointestinal tract, which can cause heartburn because the stomach's contents aren't emptying out quickly enough, resulting in excess stomach acid being produced. According to Krishnareddy, reduced motility can also contribute to constipation because waste is moving more slowly through the colon.

Medical News Today explains that treating constipation may help relieve symptoms of GERD. When stool builds up in the colon, it can increase abdominal pressure, which may worsen reflux by pushing stomach contents back into the esophagus. By improving regularity through lifestyle changes — such as increasing water and fiber intake, exercising regularly, and establishing consistent bathroom habits — people may reduce that pressure and ease GERD symptoms. However, in some cases, over-the-counter laxatives or prescription medications may be recommended. It's also a good idea to speak with your healthcare provider about any medications you are taking that might be contributing to your constipation.