What Is Acid Reflux?
Relief for Occasional and Chronic Acid Indigestion Symptoms
Jajah-sireenut / Getty Images
Medically reviewed by Robert Burakoff, MD, MPH
Acid reflux is when the esophagus (the tube carrying food from the mouth to the stomach) becomes irritated by stomach acid or bile (a fluid used for digestion). It is a common condition that causes symptoms of pain in the chest after eating, regurgitation, problems swallowing, and the feeling of a lump in the throat.
Treatment for acid reflux might include medication and lifestyle changes. This article includes information about acid reflux, including how it relates to chronic conditions, lifestyle changes that may prevent symptoms, and food choices that may help.
What Is Acid Reflux?
Acid reflux is when stomach contents and acids go back up the esophagus. It might also be called gastroesophageal reflux (GER). It’s common for people to experience symptoms of GER every so often.
This can happen because something is causing the valve (lower esophageal sphincter) at the bottom of the esophagus to relax. This valve should only open one way: to let food and liquids go down. But when it becomes relaxed, stomach contents may go back up.
If acid reflux, or GER, occurs more than a few times a week, it may be chronic (a condition that lasts a long time). Chronic acid reflux may be a condition called gastroesophageal reflux disease (GERD).
Some of the symptoms of GERD include:
Chest pain
Chronic cough
Difficulty swallowing
Heartburn, a painful burning feeling in the chest, more than twice a week
Hoarse voice
Nausea
Regurgitation, the stomach contents backing up into the esophagus or even the mouth
GERD is common, and it can happen to anyone. However, some of the risk factors for GERD include:
Having a hiatal hernia, which is when the stomach protrudes through an opening in the diaphragm
Having overweight or obesity
Pregnancy
Smoking (including secondhand smoke)
Taking medications that relax the esophageal sphincter (including antidepressants, antihistamines, asthma medications, calcium channel blockers, painkillers, and sedatives)
How to Treat Acid Reflux for Symptom Relief
Acid reflux is common. Fortunately, there are several things that can be used at home to try to stop the symptoms. Many of them can be done at home.
When to Seek Help
Acid reflux may happen every so often, such as after a big meal. However, if the symptoms go on too long or are happening more than a few times a week, it’s time to see a healthcare provider. The treatments for chronic acid reflux (which may be GERD) will be different. GERD can lead to complications, making treatment and prevention necessary.
Avoid Food Triggers
Certain types of foods might bring on symptoms. Every person is different, so it may take some trial and error to figure out which ones are the problem.
It might be possible to eat certain trigger foods in smaller amounts or singly without it resulting in acid reflux. Some foods could be a problem when eaten closer to bedtime, so avoiding them later in the day may be helpful.
Foods that may affect the lower esophageal sphincter and lead to reflux include:
Alcoholic beverages
Carbonated beverages
Chocolate
Coffee
Garlic
High-fat foods
Mint
Onions
Spicy foods
Tomatoes
Tea
Take OTC Medications
Many over-the-counter (OTC) drugs can help with acid reflux. They work in different ways, so it may be necessary to use trial and error and to work with a healthcare provider to find the right one.
Be Careful of Overreliance on OTC Drugs
If you find yourself reaching for an OTC drug more than a few times a week for heartburn, it’s time to see a healthcare provider. It may be time to make some changes to diet and lifestyle, or try a different type of drug or combination of drugs, to get the problem under control.
The types of OTC medications available include:
Antacids: Brand names include Mylanta, Rolaids, and Tums. Antacids work to neutralize stomach acid and prevent heartburn. They often work right away after taking them.
Histamine-2 (H2) blockers: These include Axid AR (nizatidine), Pepcid Complete or Pepcid AC (famotidine), and Tagamet HB (cimetidine). This class of drugs affects the stomach by reducing the amount of acid it produces. They may take between one and three hours to start working, but the effects may last several hours.
Proton pump inhibitors (PPIs): These include Nexium 24HR (esomeprazole), Prevacid 24HR (lansoprazole), Prilosec OTC (omeprazole magnesium), and Zegerid OTC (omeprazole and sodium bicarbonate). They may need to be taken for a few days (up to four) before they start working. They help reduce the amount of acid produced by the stomach. They are for use in 14-day periods
Review Your Medications
In some cases, acid reflux may be related to medications. If this is the case, it may be possible to adjust the dosage or switch to a different class of drugs to avoid the problem. Talk to a healthcare provider about how to manage this side effect if it happens.
The medications that may cause the esophageal sphincter to relax, leading to reflux can include estrogen, tricyclic antidepressants, and nonsteroidal anti-inflammatory drugs (NSAIDs), such as Advil or Motrin (ibuprofen) or Aleve (naproxen sodium).
Other medications may actually cause irritation to the esophagus. This is also personalized, but some of the drugs that are known to cause this problem include bisphosphonates Fosamax (alendronate), Boniva (ibandronate), and Actonel (risedronate). These are used to treat osteoporosis.
Elevate the Bed
Raising the head of a bed or sleeping surface may help with symptoms of acid reflux. It may help to use gravity to advantage. When laying on an incline, the acid may not be able to come up from the stomach as easily as it can when lying flat.
There are several ways to achieve an elevated head. Most often, people use a wedge pillow, which is effective. One study found that actually raising the bed itself with the use of blocks was preferred by people and might work better to control symptoms.
Related: Health Benefits of Sleeping With a Wedge Pillow
Make Lifestyle Changes
Making some changes in everyday activities can also help in reducing the chance of having reflux, or in calming symptoms if it does happen.
Here are some things to try:
Avoid exercise after eating.
Avoid laying down for three hours after eating.
Consider weight loss when recommended by a healthcare provider.
Eat smaller meals.
Stop smoking.
Related: Is Eating Before Bed Bad For You?
Severe Acid Reflux Symptoms
Some symptoms that may occur with acid reflux are considered severe. Having any of these symptoms might mean that the condition has worsened.
Seek medical care if any of the following occur:
Chest pain
Disinterest in eating
Pain when swallowing or problems swallowing
Unexplained weight loss
Vomit with blood or that looks like coffee grounds
Vomiting that won’t stop
It’s also possible for GERD to cause complications. When the signs go untreated, over time, they can lead to problems both inside and outside of the esophagus.
Some of the potential complications include:
Asthma: A chronic lung disease that makes it hard to breathe
Barrett’s esophagus: Damage to the lower part of the esophagus
Chronic cough
Esophagitis: Inflammation that could lead to ulcers (holes) and bleeding in the lining of the esophagus
Esophageal stricture: A narrowing in the esophagus that could cause problems with swallowing
Hoarse voice
Laryngitis: A loss of voice due to inflammation in the voice box
Related: Symptoms of Gastroesophageal Reflux Disease (GERD)
What Is the Treatment for Severe Acid Reflux?
When acid reflux is severe, the first step might be to try a PPI medication to see if that helps. If not, it may be time to do some testing to make sure that there isn’t another condition, such as an ulcer or eosinophilic esophagitis, causing the symptoms. If not, PPI therapy might be used intermittently (on and off).
Your healthcare provider may recommend endoscopy. A flexible tube with a light and a camera on the end is inserted into the esophagus to see what is happening inside it.
Reflux monitoring is another possible test, which is done to see how much acid is in the esophagus over a 24-hour period. A healthcare provider may also order other tests, as needed, for the symptoms.
For treatment, all the lifestyle interventions mentioned previously might be recommended first, along with a PPI. When esophagitis is a problem, surgery may be recommended. Sucralfate might be recommended for pregnant people with reflux.
Related: GERD (Heartburn) Surgery: Everything You Need to Know
Acid Reflux–Friendly Meals
Acid Reflux–Friendly Meals
It may seem as though eating for acid reflux needs to be boring or restrictive. However, there are many types of ingredients that can be used to make meals that won’t lead to symptoms.
Consider adding more of these foods to the diet:
Apples
Bananas
Broth-based soups
Cauliflower
Celery
Cucumber
Eggs
Fennel
Ginger
Herbal tea
Lettuce
Melons
Milk
Nuts
Pasta
Peanut butter
Potatoes
Sherbet
Watermelon
Food groups that may not trigger symptoms include:
Whole grains (oatmeal, couscous, and brown rice)
Root vegetables (sweet potatoes, carrots, and beets)
Green vegetables (asparagus, broccoli, and green beans)
Related: Dining Out Choices for People With Heartburn
Keeping a food and symptom diary can help. Knowing how one reacts to certain foods can help in ruling them in or out.
Summary
Acid reflux is common but it shouldn’t happen to anyone more than a few times a week. Lifestyle changes such as altering the diet and stopping smoking may help. Over-the-counter medications may also help.
If symptoms of burning or reflux are severe or are accompanied by other gastrointestinal symptoms like vomiting, it’s important to see a healthcare provider. There may be a need for more testing, prescription medications, or surgery.
