acid reflux treatment options overview

Overview

Acid reflux happens when stomach acid flows back up into your esophagus — the tube that carries food from your mouth to your stomach. This can cause a burning feeling in your chest (heartburn) and a sour taste in your mouth.

Yes. Acid reflux affects many people at some point in life. Occasional reflux after a big meal is normal, but frequent reflux may need attention.

Anyone can get acid reflux, but it is more common in adults, people who are overweight, pregnant women, and people who eat large or late meals.

Symptoms

Common symptoms

• Heartburn — a burning pain behind your breastbone
• Tasting stomach acid or food at the back of your throat (regurgitation)
• A sour or bitter taste in the mouth
• A hoarse voice or sore throat in the morning
• A nagging cough
• Trouble swallowing or feeling like food sticks

Symptoms in children

• Vomiting or spitting up more than usual
• Coughing that doesn't go away
• Fussiness around feeding times
• Poor appetite or weight gain
• A sour smell on the breath

Symptoms in older adults

• Less typical heartburn, but may have a cough, wheezing, or a lump in the throat feeling
• Chest pain that can mimic heart disease
• Trouble swallowing
• Unexplained weight loss or anaemia

Causes

Main causes

• A weak valve (lower esophageal sphincter) that normally keeps stomach contents from going back up
• A hiatus hernia — when part of the stomach slides up into the chest
• Pregnancy, which presses on the abdomen
• A large meal that overfills the stomach
• Lying down soon after eating

Risk factors

• Being overweight
• Eating large or spicy meals
• Eating close to bedtime
• Drinking alcohol or too much caffeine
• Smoking
• Stress and anxiety

When to see a doctor

See a doctor urgently if:

• You have symptoms that do not improve with over-the-counter medicines or lifestyle changes after a few weeks
• You have pain or difficulty when swallowing
• You are losing weight without trying
• You have signs of bleeding (see emergency symptoms)

Book a routine appointment if:

• You have heartburn more than twice a week
• Your symptoms keep you awake at night
• You need to use antacid remedies almost every day

Diagnosis

A doctor makes a diagnosis by asking about your symptoms and doing a physical exam. They may also arrange tests if symptoms are severe or ongoing.

Tests that may be done

• Endoscopy — a thin, flexible camera looks at the inside of your esophagus and stomach
• pH monitoring — a sensor measures acid levels in your esophagus over 24 hours
• Barium swallow — you drink a chalky liquid and have X-rays to show how well you swallow
• Esophageal manometry — a test that checks the strength of the muscle that closes off your stomach

What to expect at your appointment

At the appointment, your doctor will ask about how often you get reflux, what makes it better or worse, and what medicines you already take. They may check your belly. If you need tests, you'll be told what to expect and how to prepare.

Treatment

Treatment for acid reflux is tailored to you. Many people start with simple lifestyle changes and over-the-counter symptom relievers. If that isn't enough, your doctor may suggest prescription medicines or, in rare cases, surgery.

Self-care at home

• Eat smaller, more frequent meals
• Avoid foods and drinks that trigger your reflux, such as spicy or fatty foods, citrus, chocolate, mint, coffee, and alcohol
• Do not lie down for at least 2–3 hours after a meal
• Raise the head of your bed by about 15–20 centimetres (or use a wedge pillow)
• If you are overweight, aim to lose weight slowly
• Quit smoking if you can

Medical treatments

Several types of medicine can help. Some neutralise acid quickly, others reduce how much acid your stomach makes, and others help heal the lining of the esophagus. Because medicines work in different ways, your doctor or pharmacist can explain which approach is best for you. Always follow the instructions and ask before taking anything long-term.

When is surgery considered?

If medicine and lifestyle changes don't control your symptoms, or if you prefer not to take long-term medicines, a surgeon can strengthen the valve between your stomach and esophagus. Surgery is usually considered only after a thorough discussion with a specialist.

Living with this condition

You can live well with acid reflux by making it a habit to eat mindfully, stay upright after meals, and keep sleep elevating if needed. Track what triggers you and adjust.

Lifestyle tips

• Keep a simple diary of what you eat and how you feel
• Chew slowly and stop eating a few hours before bed
• Wear comfortable, loose-fitting clothing
• Manage stress with walks, breathing exercises, or talking to someone you trust
• Raise the head of your bed with blocks or a wedge

Diet and exercise

A balanced diet with plenty of vegetables, lean proteins, and whole grains is best. Light to moderate exercise can help with weight and digestion, but avoid vigorous activity right after eating, as it can make reflux worse.

Mental health and emotional wellbeing

Living with acid reflux can sometimes affect sleep and mood. It's normal to feel frustrated or anxious when symptoms keep coming back. Remember to talk to your doctor about both the physical and emotional side.

Prevention

You may not be able to stop acid reflux from ever happening, but you can lower the chance by keeping a healthy weight, eating in a way that suits your body, and giving yourself time to digest before lying down.

Screening programmes

There is no routine screening for acid reflux, but people with long-standing reflux may be checked for changes in the esophagus. Your doctor will decide if you need a test like an endoscopy.

Complications

If left untreated

• Long-term acid reflux can inflame and damage the esophagus
• It can cause bleeding or narrowing of the esophagus
• Some people develop a condition called Barrett's esophagus, where the cells in the lower esophagus change and slightly raise the risk of esophageal cancer

Long-term outlook

Most people with acid reflux get good relief with the right combination of lifestyle changes and treatment. Even if your symptoms have lasted a long time, taking action can prevent damage and improve how you feel. You are not alone, and help is available.

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