What Is Acid Reflux?
Acid reflux occurs when stomach acid flows backward into the esophagus, causing irritation and a burning sensation commonly known as heartburn. Many people experience occasional reflux, particularly after consuming large meals or specific foods.
While occasional reflux is normal, frequent or persistent reflux can become a more serious problem. When symptoms occur regularly, more than twice a week, it may indicate Gastroesophageal Reflux Disease (GERD), a chronic condition that can lead to long-term complications if left untreated.
Symptoms
Acid reflux symptoms often appear after eating and may worsen when lying down or bending over.
Common symptoms include:
- Heartburn (burning feeling in the chest or throat)
- Sour or bitter taste in the mouth
- Regurgitation of acid or food
- Bloating or discomfort after meals
- Persistent cough or throat clearing
- Hoarseness, especially in the morning
If these symptoms become frequent, more intense, or impact daily life, it may be a sign of GERD.
How Acid Reflux Becomes GERD
Acid reflux becomes a serious condition when it:
- Occurs often (2+ times per week)
- Lasts for long periods of time
- Causes inflammation in the esophagus
- Interferes with sleep or daily activities
- Does not improve with lifestyle changes or over-the-counter medications
Over time, repeated exposure to stomach acid can weaken the lower esophageal sphincter (LES), the muscle that normally prevents reflux. This leads to chronic reflux, also known as GERD.
Untreated GERD can cause complications such as:
- Esophagitis (inflammation)
- Esophageal strictures (narrowing)
- Chronic cough or voice changes
- Barrett’s Esophagus (a precancerous condition)
- Increased risk of esophageal cancer
Early treatment of acid reflux helps prevent this progression.
Causes & Risk Factors
What Causes Acid Reflux?
Reflux occurs when the LES relaxes at the wrong time, allowing acid to rise.
Common triggers include:
- Large or high-fat meals
- Spicy, fried, or acidic foods
- Coffee, alcohol, and carbonated drinks
- Chocolate or peppermint
- Smoking or vaping
- Lying down soon after eating
Risk Factors for Frequent Reflux or GERD
You may be more likely to develop chronic reflux if you:
- Are overweight or obese
- Are pregnant
- Smoke
- Eat late at night
- Have a hiatal hernia
- Take certain medications (sedatives, antihistamines, asthma medications)
Diagnosis
Most cases of acid reflux are diagnosed based on symptoms. If symptoms are persistent or severe, your provider may recommend:
- Upper Endoscopy: Looks for inflammation or complications
- pH Monitoring: Measures how often acid enters the esophagus
- Esophageal Manometry: Evaluates esophageal muscle function
These tests help determine whether reflux has progressed into GERD.
Treatment Options
Treatment depends on the frequency and severity of symptoms.
Lifestyle Changes
These modifications can significantly reduce acid reflux:
- Avoid trigger foods
- Eat smaller, more frequent meals
- Don’t lie down for 2–3 hours after eating
- Maintain a healthy weight
- Sleep with your head elevated
- Limit caffeine and alcohol
- Quit smoking
Medications
Your provider may recommend:
- Antacids: Quick relief for occasional symptoms
- H2 Blockers: Reduce acid production
- Proton Pump Inhibitors (PPIs): Most effective for healing inflammation and treating GERD
Advanced Treatments for GERD
If acid reflux has progressed to GERD and does not improve with medications, minimally invasive procedures may be considered, such as:
- LINX® magnetic sphincter augmentation
- Nissen fundoplication
- Endoscopic procedures to strengthen the LES
Prevention & Long-Term Management
To reduce or prevent acid reflux:
- Identify and avoid personal food triggers
- Minor reduction in body weight can significantly reduce symptoms
- Maintain a balanced, low-acid diet
- Eat meals earlier in the evening
- Reduce stress when possible
- Wear loose-fitting clothing
Consistent management helps prevent acid reflux from progressing into GERD or causing long-term esophageal damage.
When to Seek Care
See a provider if you experience:
- Heartburn more than twice per week
- Persistent symptoms despite over-the-counter medications
- Difficulty swallowing
- Chest pain unrelated to the heart
- Chronic cough, hoarseness, or throat irritation
- Unintentional weight loss
- Symptoms that worsen at night
Early evaluation can help control symptoms, improve quality of life, and prevent complications such as GERD or Barrett’s Esophagus.