Acid reflux, also known as gastroesophageal reflux (GER), happens when stomach acid or food flows back into the esophagus. This occurs when the lower esophageal sphincter (LES) relaxes or becomes weak, leading to symptoms such as a burning feeling in the throat or chest (heartburn), a bitter taste in the mouth, burping, nausea, and bloating. Many people experience acid reflux occasionally, particularly after a large meal or lying down soon after eating. While occasional acid reflux is normal, frequent occurrences may indicate gastroesophageal reflux disease (GERD). Around 20% of people in the U.S. live with GERD. Treatment usually involves lifestyle changes and medications.

Types

There are two primary types of acid reflux: gastroesophageal reflux (GER) and gastroesophageal reflux disease (GERD). The difference lies in the frequency and severity of the symptoms.

Gastroesophageal Reflux (GER)

GER occurs when the LES relaxes, allowing stomach contents to move back into the esophagus. This can lead to symptoms like burning sensations in the chest and throat, regurgitation, and burping. GER is common and may result from eating spicy or fatty foods, consuming carbonated drinks or citrus juices, and certain health conditions or medications. GER is also known by other names such as heartburn, reflux, acid reflux, and acid indigestion.

Gastroesophageal Reflux Disease (GERD)

GERD is a chronic form of acid reflux where symptoms persist and cause damage to the esophagus. In addition to the typical GER symptoms, people with GERD may also have trouble swallowing, chest pain, chronic cough, and throat irritation. Without treatment, GERD can lead to more serious health issues.

Acid Reflux Symptoms

Symptoms of acid reflux differ between individuals. While some people have no symptoms, others may experience:

  • A burning sensation in the chest or throat, especially after eating, lying down, or bending over

  • Bitter or sour taste in the mouth due to regurgitation

  • Burping

  • Bad breath

  • Sensation of a lump in the throat

  • Sore throat

  • Hiccups

  • Bloating

  • Nausea

  • Dry cough

What Causes Acid Reflux?

Acid reflux happens when the LES, a ring of muscle at the end of the esophagus, relaxes at the wrong time or becomes weak. This allows stomach contents to move upward into the esophagus. Common causes and contributors include:

  • Obesity, which puts extra pressure on the stomach

  • Hiatal hernia, a condition where part of the stomach pushes through the diaphragm

  • Pregnancy, due to hormonal changes and increased abdominal pressure

Risk Factors

Several factors can increase the risk of developing acid reflux:

  • Smoking

  • Large meals

  • Lying down or exercising right after eating

  • Eating trigger foods (spicy, acidic, or fatty)

  • Certain medications, such as beta-blockers, sedatives, antihistamines, and antidepressants

  • High stress levels

  • Anxiety

  • Poor sleep habits

Diagnosis

Diagnosing acid reflux is usually based on symptoms. For occasional cases, over-the-counter treatments may be sufficient. However, frequent symptoms may require medical evaluation.

A healthcare provider may use your medical history, symptom description, and physical exam to make a diagnosis. When symptoms are frequent or suggest complications, additional tests might be recommended, including:

  • Upper gastrointestinal endoscopy: A camera on a flexible tube is used to check the esophagus and stomach for damage.

  • Esophageal pH monitoring: Measures acid levels in the esophagus over time using a capsule or thin tube.

  • Barium swallow: Involves drinking a barium solution that shows up on X-rays to identify issues in the esophagus, throat, or stomach.

  • Esophageal manometry: Measures the strength and coordination of esophageal muscles with a thin tube.

Treatments for Acid Reflux

Treatment generally includes a combination of lifestyle adjustments and medications.

Lifestyle Modifications

These changes can help control or reduce acid reflux symptoms:

  • Avoid trigger foods such as spicy, fatty, or acidic items (e.g., citrus, tomatoes, fried foods, coffee, peppermint)

  • Eat smaller, more frequent meals

  • Lose weight if overweight

  • Avoid lying down for at least 2-3 hours after meals

  • Elevate the head of the bed by 6-8 inches to reduce nighttime reflux

  • Quit smoking and avoid secondhand smoke

Medications

Over-the-counter and prescription medications may be used:

  • Antacids: Quickly neutralize stomach acid (e.g., Tums, Rolaids, Maalox)

  • H2-receptor blockers: Decrease acid production with longer-lasting relief (e.g., Tagamet, Pepcid)

  • Proton pump inhibitors (PPIs): Block acid production more effectively than H2 blockers (e.g., Prilosec, Nexium, Prevacid)

For persistent symptoms, doctors may prescribe stronger medications or combinations to manage reflux.

Prevention

To prevent or minimize acid reflux:

  • Maintain a healthy weight

  • Avoid known trigger foods

  • Eat smaller meals

  • Wait a few hours after eating before lying down

  • Raise the head of your bed

  • Avoid smoking

  • Limit alcohol and caffeine intake

Complications

Occasional reflux doesn’t usually cause harm, but chronic untreated GERD may lead to:

  • Esophagitis: Inflammation, ulcers, or bleeding in the esophagus

  • Barrett’s esophagus: Tissue changes that increase cancer risk

  • Esophageal stricture: Scarring that narrows the esophagus and affects swallowing

Additional issues may include:

  • Breathing problems like chronic cough or asthma

  • Tooth enamel erosion

  • Laryngitis or voice hoarseness

Living With Acid Reflux

For most people, acid reflux can be managed with lifestyle changes and occasional medications. Avoiding trigger foods, eating smaller meals, and maintaining a healthy weight are effective strategies.

If you experience frequent symptoms, it may be GERD, which requires professional diagnosis and treatment to prevent complications. With proper care, most people can manage GERD and live comfortably.