Conditions & symptoms · Digestive health
What causes acid reflux, and what can help?
Understand reflux symptoms and contributors, practical ways to reduce episodes, treatment choices and the warning signs that need prompt or emergency assessment.
What causes acid reflux, and what can help?
Acid reflux happens when stomach contents move back into the oesophagus, causing heartburn, a sour taste or regurgitation. Smaller meals, avoiding lying down after eating and changing only the triggers that affect you may help. Persistent or frequent symptoms deserve GP review. Call 000 for severe, worsening or uncertain chest pain, or chest pain lasting 10 minutes.
What does acid reflux feel like?
Reflux commonly causes a burning feeling behind the breastbone, an acidic or bitter taste, or the feeling that food or fluid is coming back into the throat. Some people also have belching, nausea, an irritated throat or a cough, especially after meals or when lying down.
Heartburn describes the burning symptom. Acid reflux describes stomach contents moving upwards. Gastro-oesophageal reflux disease, or GORD, is the term used when reflux is frequent or persistent, causes troublesome symptoms, or leads to inflammation or other complications. An occasional episode does not by itself mean you have GORD.
Chest discomfort cannot always be safely identified as heartburn from symptoms alone. Use the emergency guidance below if pain is severe, worsening, lasts 10 minutes, or you are unsure whether it could be a heart problem.
What can cause or worsen reflux?
Reflux occurs when the valve between the oesophagus and stomach does not keep stomach contents down effectively. Large meals, lying down soon after eating, pregnancy and increased pressure on the abdomen can make reflux more likely.
Food and drink triggers vary. Fatty or spicy food, alcohol, caffeine, chocolate or acidic food affects some people but not everyone. Notice your own pattern before cutting out broad food groups, especially if restrictions would make it harder to eat well.
Some medicines can worsen reflux or irritate the oesophagus. Do not stop prescribed treatment yourself. A GP or pharmacist can review whether a medicine may contribute and discuss a safe alternative or timing change when appropriate.
Practical steps that may help
Small, targeted changes are easier to assess than changing everything at once. Keep a brief note of meal timing, position, symptoms and any likely trigger if the pattern is unclear.
- Try smaller meals if large meals bring on symptoms.
- Leave at least three hours between eating and lying down or going to bed.
- Reduce only the foods or drinks that consistently trigger your symptoms rather than following a long exclusion list.
- If symptoms occur at night, raising the head end of the bed may help. Extra pillows alone can bend the body and may not have the same effect.
- If smoking, alcohol or weight around the abdomen contributes, discuss a realistic change plan with a clinician rather than relying on a quick fix.
When can a pharmacist or treatment help?
A pharmacist can discuss short-term options such as treatments that neutralise or form a barrier against stomach acid, and check what is suitable with your medicines, pregnancy and health conditions. Some treatments reduce acid production and may need clinician advice when symptoms are frequent or ongoing.
Follow the label or clinician's instructions. Ask how long to try a treatment and when to seek review. Repeated self-treatment can mask a problem that needs assessment, and symptom relief does not prove the discomfort came from reflux.
Avoid using someone else's medicine or combining products without advice. A GP can help choose the next step when pharmacy treatment is unsuitable, does not help, or is needed repeatedly.
How can a HerDoc GP help?
A HerDoc GP can review the symptom pattern, meal timing, medicines, pregnancy possibility, health history and what you have tried. The GP can discuss a treatment plan and whether tests, local examination or referral would add useful information.
HerDoc consultations are by phone. A local clinician may need to examine you when chest or abdominal findings matter, and swallowing difficulty, bleeding or severe symptoms may need urgent in-person assessment. A phone consultation cannot examine your abdomen, heart or lungs.
Tests are not required for every episode. They may be considered when symptoms persist, do not respond as expected, or another condition is possible. The GP should explain what any test or referral is intended to answer.
What if reflux persists or keeps returning?
Arrange GP review if symptoms are frequent, keep returning, wake you at night, affect eating or daily life, or continue despite reasonable self-care and pharmacy advice. Bring the names of treatments tried and how often you use them.
Seek earlier assessment for food sticking or painful swallowing, persistent vomiting, unexplained weight loss, reduced appetite or anaemia. Blood in vomit or black, tar-like stools needs emergency assessment; follow the urgent-care section below. These features can have causes other than reflux and may change which examination or tests are needed.
Long-term care should match the cause and response. It may involve targeted lifestyle changes, a medicine review, a time-limited treatment trial, testing or referral rather than indefinite self-treatment.
Useful details for your appointment
A few notes about the pattern can help the GP distinguish likely reflux from other causes of chest or upper-abdominal symptoms.
- Where you feel the symptom and whether it burns, presses, spreads or changes with activity.
- When it began, how often it happens and how long episodes last.
- Links with meals, particular foods or drinks, bending, exercise, lying down or sleep.
- Sour taste, regurgitation, cough, swallowing difficulty, vomiting, bleeding, appetite or weight change.
- Current medicines, pregnancy possibility and treatments already tried.
- Heart, lung or digestive conditions and relevant family history.
When should you seek urgent care?
Do not assume chest pain is reflux when the pattern is new, severe or uncertain. Emergency assessment matters because heart and other serious conditions can cause similar symptoms.
Call 000 now for chest pain
Call 000 for severe or worsening chest pain, chest pain lasting 10 minutes, or any chest pain you are unsure about. Call straight away if severe symptoms are already present rather than waiting 10 minutes.
- Pain, pressure, tightness or heaviness that spreads to an arm, shoulder, jaw, back or neck.
- Chest discomfort with shortness of breath, sweating, nausea, dizziness, faintness or sudden weakness.
- Collapse, severe breathing difficulty or feeling seriously unwell.
Go to an emergency department now
Call 000 if you are faint, collapse, are very unwell or cannot travel safely.
- Vomiting blood or material that looks like coffee grounds, or passing black, tar-like stools.
- Severe upper-abdominal pain, repeated vomiting or inability to keep fluids down.
- New inability to swallow or food stuck in the throat or chest.
Arrange prompt local medical review
- Painful swallowing that is new or getting worse.
- Persistent vomiting, unexplained weight loss, reduced appetite or symptoms of anaemia.
Sources and further reading
Further information about reflux symptoms, practical care and medical review is available from these health services.
Discuss ongoing reflux symptoms with a GP
A GP can review the pattern, contributing factors and next steps. Use urgent local care for chest pain, bleeding, severe symptoms or swallowing difficulty.
Related pages
FAQs
Is heartburn the same as GORD?
Heartburn is the burning symptom that reflux can cause. GORD describes reflux that is frequent or persistent, causes troublesome symptoms, or leads to complications. An occasional episode does not automatically mean GORD.
Do I need to avoid every common reflux trigger?
No. Triggers vary between people. Note which foods, drinks, meal sizes or positions repeatedly bring on your symptoms and change those first. Ask a GP or dietitian before a broad restriction that could make it harder to eat well.
Why is raising the bed different from using extra pillows?
Raising the head end of the bed keeps the upper body on an incline. Extra pillows can bend the body at the waist and may increase pressure on the abdomen. Ask for advice if lifting the bed is not safe or practical for you.
When is chest pain an emergency?
Call 000 for severe or worsening chest pain, pain lasting 10 minutes, or chest pain you are unsure about. Call immediately when severe symptoms are already present. Symptoms with breathlessness, sweating, nausea, faintness or pain spreading to the arm, jaw, back or neck are also emergencies.