Do Onions and Bell Peppers Cause Heartburn?

Onions and bell peppers hold a flavorful presence in many everyday dishes, but they may be a trigger food for heartburn. To directly answer whether or not they cause heartburn, it truly depends on the individual. Heartburn occurs when refluxed acid comes in contact with the esophagus and causes an uncomfortable burning sensation in the chest. The American College of Gastroenterology estimates that more than 60 million Americans experience heartburn once a month, and 15 million have daily symptoms of heartburn. For some heartburn sufferers, onions and bell peppers may cause symptoms, but not for all.

Onions have long been on the list of forbidden foods for individuals with heartburn. Raw onions, in particular, have been known to lower the pressure of the lower esophageal sphincter, the muscle that keeps food from flowing back into the esophagus. In addition, raw onions are known as carminatives, a class of foods rich in volatile oils that includes peppermint and garlic, and that can produce heartburn symptoms in many people. It is also possible that raw onions cause an increase in gastric secretions, which could cause heartburn symptoms. Most studies have been done on raw onions with no specific type mentioned. Raw, cooked or dehydrated onions can all be eaten if they do not personally cause heartburn symptoms.

Bell peppers are not typically on the list of commonly avoided foods for heartburn. There is no current research to indicate that bell peppers cause heartburn symptoms. In fact, the University of Maryland Medical Center advises heartburn patients to consume antioxidant-rich foods, including bell peppers, as part of a daily diet. With a pH level ranging from 4.8 to 5.2, bell peppers tend to be more alkaline than acidic. It may seem smart to shy away from all peppers, but bell peppers do not contain capsaicin, the substance responsible for giving hot peppers their spice. Different people have different food tolerances, however, and if bell peppers seem to predictably aggravate heartburn, it may be best to avoid them.

Specific foods may aggravate and contribute to heartburn, but there is no research to indicate that any certain food is the underlying cause. The American College of Gastroenterology's 2013 clinical guidelines, published in the "American Journal of Gastroenterology," do not recommend eliminating entire groups of foods if they do not cause symptoms. It is more important to identify the foods that personally trigger heartburn and eliminate those foods from the diet. Other recommendations that may help ease symptoms include weight loss, avoiding large meals, not lying down immediately after eating and smoking cessation.

If symptoms of heartburn are persistent, rather than occasional, are severe or are causing a fear of eating or weight loss, see a medical doctor as soon as possible. Also see a doctor if you're experiencing heartburn with nausea or vomiting, bad breath, difficulty swallowing or abdominal pain, since this could indicate a more serious problem. For persistent acid reflux, a doctor can recommend lifestyle changes, suggest medication to suppress stomach acid, or enlist the help of a registered dietitian who can evaluate the current diet and recommend modifications.