What is acid reflux?

Acid reflux is a common digestive problem, and about 20% of Americans suffer from chronic reflux. If you experience acid reflux, understanding what it is and how it’s treated can help guide conversations about your symptoms and care plan with your healthcare provider.

Also referred to as gastroesophageal reflux (GER), acid reflux is when food and acids from your stomach back up into your esophagus, the tube that connects your stomach and mouth.

After you swallow, a muscle called a sphincter opens to allow food to enter your stomach. When functioning normally, the sphincter then closes tightly to prevent your stomach contents from escaping. In people with acid reflux, the sphincter doesn’t work properly, leading to leakage.

Acid reflux can cause a variety of symptoms, including heartburn, which is characterized by a burning sensation in the chest. Heartburn occurs due to the presence of stomach acid in the lower esophagus.

You’ll often see acid reflux and GERD discussed together. GERD stands for gastroesophageal reflux disease, a condition that occurs when a person experiences repeated bouts of acid reflux over a long period of time.

There are many factors that can cause acid reflux. In some cases, acid reflux is caused by more than one factor. Potential causes of acid reflux include:

• Being overweight or obese
• Gas and indigestion
• Hiatal hernia
• Medications like birth control pills and some drugs used to treat high blood pressure
• Smoking cigarettes or being exposed to secondhand smoke
• Reclining too soon after eating

Some people experience acid reflux when they consume certain foods and beverages that affect the lower sphincter in the esophagus. Some drinks and foods that cause acid reflux include:

• Alcohol
• Chocolate
• Caffeinated beverages, like coffee, and carbonated drinks, like sodas
• Citrus fruits and products that contain citrus juice, like orange juice
• Fatty or fried foods, like bacon and french fries
• Onions
• Peppermint
• Tomatoes and tomato-based products, like spaghetti sauce
• Spicy foods

While it’s possible to experience acid reflux at any time of day, some people are more prone to symptoms at night, especially if they eat a meal close to bedtime. Lying down increases pressure on the abdomen, which can cause the sphincter muscle to open. 

When you vomit, the acids present in your stomach come up along with food. This can lead to irritation in the esophagus and trigger heartburn.

During periods of stress, your body functions differently. Your digestive system slows down and stomach acid production increases. These changes can lead to acid reflux or make existing reflux symptoms worse.

Acid reflux is common during pregnancy. Changes in hormone levels and increased pressure on the abdomen due to changes in weight can cause heartburn and other GERD symptoms.

Many people describe heartburn from acid reflux as a burning sensation in the upper chest. The discomfort may worsen when you lie down or bend over. It can last for just a few minutes to a few hours.

Heartburn due to acid reflux feels like a pain in the chest. However, chest pain can also be a symptom of a heart attack or other heart problem. If you have persistent chest pain that you’re not sure is due to heartburn, seek emergency medical attention.

The burning sensation associated with acid reflux may be experienced in the lower throat. It may also be centered behind the breastbone and feel like it’s radiating into the throat.

Nausea or an upset stomach can occur with acid reflux. You might experience nausea on its own or along with heartburn and other GERD symptoms.

Heartburn associated with acid reflux or GERD may sometimes be felt in other parts of the body. Some people report discomfort between their shoulder blades or in the region between their upper and mid-back areas.

Heartburn is one of the most common symptoms of acid reflux, but the condition can present in other ways as well. Some additional symptoms of GERD include:

• Regurgitating stomach contents into your mouth, causing you to taste acid
• Difficulty swallowing
• Chronic cough
• Hoarseness
• Burping
• Sour taste in your mouth
• Stomach bloating
• Hiccups
• Sore throat

An acid reflux treatment plan often includes self-care and other interventions. The following are some treatment options for acid reflux:

1.   Changes to lifestyle and diet

Modifying your diet and making changes to your lifestyle may help reduce acid reflux symptoms. Your healthcare provider may recommend that you:

●     Keep a food journal to identify triggers, and then avoid foods that cause symptoms

●     Quit smoking

●     Eat smaller, more frequent meals

●     Stop eating two to three hours before bedtime

●     Elevate your head in bed if you experience acid reflux at night

●     Avoid wearing tight clothes that can put pressure on your abdomen

●     Sleep on your left side to reduce abdominal pressure

●     Lose extra weight through diet and exercise

2.   Over-the-counter acid reflux medicine

Healthcare providers often recommend over-the-counter acid reflux medications as
first-line treatments for mild to moderate acid reflux. These include:

●     Antacids: These medications neutralize stomach acid to quickly relieve heartburn associated with acid reflux. Antacids are usually intended for intermittent, infrequent use. Taking them long-term for chronic GERD may worsen your condition.

●     H2 blockers: Drugs like cimetidine, famotidine and nizatidine reduce the amount of acid that your stomach produces and may help heal esophageal erosions in some people. They typically start to take effect in one to three hours and continue to work for several hours.

●     Proton pump inhibitors: For acid reflux that occurs two or more days per week, healthcare providers may recommend proton pump inhibitors like esomeprazole, lansoprazole or omeprazole. These medications reduce stomach acid levels and are typically taken for up to 14 days but may be prescribed for longer.

Although you don’t need a prescription to buy these medications, consult with your healthcare provider before taking them, as they may interact with other medications you take, and they may not be appropriate for people with certain medical conditions.

3.   Prescription medicine for acid reflux

In many cases, over-the-counter medications are effective for treating acid reflux. However, if they fail to fully relieve symptoms, healthcare providers may prescribe different types and strengths of medications to help. Steroids may be prescribed as well to ease inflammation.

4.   Other interventions for acid reflux

Surgical procedures may be recommended when medications fail to relieve symptoms or for people who are unable to safely take acid reflux drugs. Surgical interventions for acid reflux include:

●     Nissen fundoplication, where a surgeon tightens the esophageal sphincter muscle by wrapping the top of your stomach around it

●     Transoral incisionless fundoplication (TIF) is performed through the mouth, without incisions. A surgeon uses a tool called an endoscope to tighten the junction between the esophagus and the stomach.

●     LINX device placement, where a surgeon implants a small ring outfitted with magnets to help keep the sphincter shut

Drinking a glass of milk is one of the most well-known natural remedies for acid reflux. Nonfat milk may help provide immediate relief by soothing the stomach from acidic food and contents. However, milk won’t address the underlying causes of acid reflux and shouldn’t be relied on to treat chronic GERD. Fat in milk can also make reflux worse.

There are many ways to treat acid reflux. The right treatment options for you will depend on the cause of your symptoms, your age, your health history and other factors. Your healthcare provider can work with you to develop a treatment plan based on your individual needs.

Updated December 2023.