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Here are the main causes of heartburn: Gastroesophageal reflux disease (GORD) Hiatus hernia, when part of your stomach moves up into your chest Surgery youve had in the past (especially bariatric surgery) Certain foods and drinks, such as alcohol, coffee, chocolate, and fatty or spicy foods Being overweight Smoking Pregnancy Stress or anxiety Medication, such as anti-inflammatory painkillers Overgrowth of bacteria in your small intestine (this is called SIBO) Diagnostic testing allows us to pinpoint the exact cause so we can recommend the right solution