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Acid reflux

Acid reflux, more commonly called ‘heartburn’, is a painful sensation caused by stomach acid travelling up the ‘food-pipe’ (oesophagus) and towards the throat.

Acid reflux usually due to a laxity in the lower oesophageal sphincter. This sphincter forms a tight ring between the top of the stomach and bottom of the oesophagus. It opens to let food pass from the oesophagus and into the stomach, and then closes again to prevent stomach acid and food travelling the wrong way back into the oesophagus. With acid reflux, this sphincter is more relaxed than it should be, allowing acid to pass out of the stomach and cause painful symptoms.

Acid reflux is very common. Approximately 40% of the adult population experience symptoms (usually mild) at some point throughout the year.

Acid reflux, or heartburn, can happen at any time, but common causes include:

  • Big meals
  • Lying down or bending over
  • Alcohol
  • Caffeine
  • Spicy foods
  • Fried or fatty foods
  • Smoking
  • Being overweight
  • Pregnancy
  • Stress and anxiety
  • Certain medications (like ibuprofen)

If acid reflux keeps occuring, it’s called ‘Gastro-oesophageal reflux disease’ (GORD).

A pain at the top of the abdomen and/or middle of the chest
Typically described as a burning pain – hence the term ‘heartburn’

Some people may also experience:

  • Bad breath
  • Cough
  • Hoarse voice
  • Sour or bitter taste in the mouth
  • Nausea
  • Sensation of something in the back of the throat

Most acid reflux can be treated easily with lifestyle adaptations and behavioural change. Here are simple changes to reduce acid reflux:

  • Eat smaller portions
  • Eat slowly and don’t rush meals
  • Avoid eating late at night (ideally eat 3-4 hours before bed), and sit upright after eating
  • Raise the head of your bed slightly so you’re not lying flat when you sleep
  • Drink below the recommended amount of alcohol, which is 14 units per week
  • Cut down on coffee, spicy foods, fatty foods and acidic foods (like tomatoes, lemons, oranges)
  • Aim for a BMI between 18.5-25
  • If you smoke, consider stopping (a GP will be able to help you find a local smoking cessation programme)
  • Avoid taking anti-inflammatory medication like ibuprofen (unless you’ve been told to by a doctor)

If lifestyle changes have not improved your heartburn symptoms, medications can be bought from a pharmacy. These include antacid tablets, or liquids which act to neutralise the stomach acid. They’re best taken with food, or shortly after eating.

If symptoms are ongoing, a GP may offer you a prescription for a medication to reduce the amount of acid produced in the stomach. These medications are typically taken daily for one to two months. You could also have tests to check for bacteria that can live in the stomach and make acid reflux symptoms worse.

If medications do not help your symptoms or you’re in severe pain, a GP may refer you for further tests with a gastroenterologist. This involves an endoscopy procedure – a camera put down the throat to have a look at the stomach.

If you’ve tried over-the-counter medications from a pharmacy and still have symptoms
If you have severe symptoms affecting your sleep, or are in significant discomfort
If you have difficulty swallowing, unexplained weight loss, frequent vomiting or have vomited blood.

Last updated:
12 Nov 2020
Reviewed by:
Dr Rhianna McClymont, Lead GP at Livi