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The extra gas in carbonated water creates more pressure in your stomach, increasing the chances that your stomach will regurgitate contents upward. Some carbonated waters also include natural flavorings, such as lemon or lime, which can increase acidic content, making the heartburn worse.
Simethicone is an anti-foaming agent that decreases the surface tension of gas bubbles, causing them to combine into larger bubbles in the stomach that can be passed more easily. Simethicone does not reduce or prevent the formation of gas in the digestive tract, rather, it increases the rate at which it exits the body.