Acid reflux happens when contents from your stomach move back up into your esophagus. This action is also called acid regurgitation or gastroesophageal reflux.
If you have symptoms of acid reflux more than twice a week, you might have a condition known as gastroesophageal reflux disease (GERD).
According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)Trusted Source, GERD affects about 20 percent of people in the United States. If left untreated, it can sometimes cause serious complications.
Is acid reflux the same as GERD?
Acid reflux and gastroesophageal reflux disease (GERD) are closely related, but the terms don’t necessarily mean the same thing.
Acid reflux, also known as gastroesophageal reflux (GER), is the backward flow of stomach acid into the tube that connects your throat to your stomach (esophagus). During an episode of acid reflux, you might feel a burning sensation in your chest (heartburn). This can occur after eating a big meal or drinking coffee or alcohol.
Sometimes acid reflux progresses to GERD, a more severe form of reflux. The most common symptom of GERD is frequent heartburn — two or more times a week. Other signs and symptoms can include regurgitation of food or sour liquid, difficulty swallowing, coughing, wheezing, and chest pain — especially while lying down at night.
If you have occasional acid reflux, lifestyle changes can help. Lose excess weight, eat smaller meals, don’t eat two to three hours before bedtime, raise the head of your bed, and avoid foods that seem to trigger heartburn — such as fried or fatty foods, chocolate, and peppermint. Don’t wear tight clothing around your abdomen, and avoid alcohol and tobacco.
If necessary, occasional acid reflux can be treated with over-the-counter medication, including:
- Antacids, such as Tums or Maalox
- H-2-receptor blockers, such as cimetidine (Tagamet HB) or famotidine (Pepcid AC)
If you suspect that you have GERD, your signs and symptoms worsen, or you have nausea, vomiting or difficulty swallowing, talk to your doctor. Prescription medications might help. In a few cases, GERD might be treated with surgery or other procedures.
The main symptom of GERD is acid reflux. Acid reflux can cause an uncomfortable burning feeling in your chest, which can move up into your neck and throat. This feeling is often known as heartburn.
If you have acid reflux, you might develop a sour or bitter taste at the back of your mouth. It might also cause the regurgitation of food or liquid from your stomach into your mouth.
Some other symptoms of GERD include:
- chest pain
- pain when swallowing
- difficulty swallowing
- chronic cough
- a hoarse voice
- bad breath
GERD treatment options
To manage and relieve symptoms of GERD, your doctor might encourage you to make certain lifestyle changes, like:
- maintaining a moderate weight, if applicable
- quitting smoking, if you smoke
- avoiding big, heavy meals in the evening
- waiting a few hours after eating to lie down
- elevating your head during sleep (by raising the head of your bed 6-8 inches)
Your doctor might also suggest taking over-the-counter (OTC) medications like those listed below. All of these medications can cause side effects, so talk with your doctor about which option is the best for you.
Antacids like Tums are typically used for occasional and mild symptoms of acid reflux and GERD. But if you find that you’re taking antacids almost every day, you may need a stronger medication.
H2 receptor blockers
H2 blockers like Pepcid AC work to lower the amount of acid your stomach makes. Many H2 blockers are available OTC, while higher doses of these medicines can also be prescribed.
It’s important to note is that one type of H2 blocker — ranitidine (also known as Zantac) — was recently recalled by the FDA for containing the ingredient N-Nitrosodimethylamine (NDMA), which is a known carcinogen.
Proton pump inhibitors (PPIs)
PPIs like Prilosec also lower the amount of acid your stomach makes. Because they tend to work better than H2 blockers, they’re more helpful when it comes to healing the esophageal lining — which can become damaged when someone is dealing with GERD for a while.
Like H2 blockers, you can buy some PPIs OTC, and your doctor can also prescribe you a higher dose.
The problem with home remedies for GERD
Some individuals might prefer to start with home remedies to treat their heartburn. While certain home remedies may help a little when it comes to occasional bouts of acid reflux, if you’ve been diagnosed with GERD, you’re most likely dealing with a chronic issue.
Chronic health issues can sometimes be eased by lifestyle changes, but also typically need some kind of medical intervention. When it comes to chronic issues, it’s best to resist the desire to self-diagnose and self-medicate. Talk with your doctor before starting any new treatments.
A few home remedies floating around out there that may do more harm than good include:
- Drinking a baking soda and water solution. Because baking soda is alkaline, it has the ability to help neutralize acidity, and is mostly safe to consume in small doses. But baking soda is high in sodium, and it’s also possible to experience side effects if you consume too much.
- Chewing gum. The thought here is that because saliva is slightly alkaline, stimulating it by chewing gum after eating may help neutralize the acidity in your mouth and throat. While a very small study from 2005 did find some merit to this approach, the size of the study makes it difficult to draw any real conclusions.
- Consuming ginger. Ginger is a common home remedy for issues like nausea and a sour stomach, but it’s still unclear if it can actually help with occasional heartburn symptoms. In fact, in many studies, heartburn is a symptom of taking too much ginger.
- Drinking milk. Due to its natural alkalinity, milk is another home remedy that’s often touted as a way to ease heartburn symptoms. Unfortunately, even though it may feel soothing initially, the fat and protein it contains can ultimately make heartburn symptoms worse once the milk is digested. Low fat milk may be easier for some people to tolerate.
If your doctor suspects you might have GERD, they’ll conduct a physical exam and ask about any symptoms you’ve been experiencing.
Your doctor may then recommend you to a gastroenterologist, or may conduct certain tests themselves, including:
- Ambulatory 24-hour pH probe. A small tube is sent through the nose into the esophagus. A pH sensor at the tip of the tube measures how much acid exposure the esophagus is getting, and sends the data to a portable computer. An individual wears this tube for about 24 hours. This method is generally considered the “gold standard” for diagnosing GERD.
- After drinking a barium solution, X-ray imaging is used to examine your upper digestive tract.
- Upper endoscopy. A flexible tube with a tiny camera is threaded into your esophagus to examine it and collect a sample of tissue (biopsy) if needed.
- Esophageal manometry. A flexible tube is passed through the nose into your esophagus to measure the strength of your esophageal muscles.
- Esophageal pH monitoring. A monitor is inserted into your esophagus to learn how acid is regulated in your body over a period of a few days.
After arriving at a diagnosis, your doctor will decide what interventions will work best for you, and if surgery is an option.
Surgery for GERD
In most cases, lifestyle changes and medications are enough to prevent and relieve symptoms of GERD.
But sometimes, surgery is needed.
For example, your doctor might recommend surgery if lifestyle changes and medications alone haven’t stopped your symptoms. They might also suggest surgery if you’ve developed complications of GERD.
There are multiple types of surgery available to treat GERD, including fundoplication (during which the top of your stomach is sewn around your esophagus), and bariatric surgery (usually recommended when a doctor has concluded that your GERD may be exacerbated by too much excess weight).
While there’s no single cause of GERD, there is a mechanism in your body that — when not functioning properly — can increase the likelihood of it.
The lower esophageal sphincter (LES) is a circular band of muscle at the end of your esophagus. When it’s working correctly, it relaxes and opens when you swallow. Then it tightens and closes again afterward.
Acid reflux happens when your LES doesn’t tighten or close properly. This allows digestive juices and other contents from your stomach to rise up into your esophagus.
Other possible causes include:
- Hiatal hernia. This is when a part of the stomach moves above the diaphragm towards the chest area. If the diaphragm is compromised, it can increase the likelihood that your LES can’t do its job correctly.
- Frequently eating large meals. This can cause the distension of the upper part of the stomach. This distension sometimes means there isn’t enough pressure on the LES, and it doesn’t close properly.
- Lying down too soon after large meals. This can also create less pressure than the LES needs to function properly.