UNC Health Care
stomach with acid in it

Your Burning Chest: How to Stop Acid Reflux and GERD

If you’ve ever felt a fiery sensation behind your breastbone or tasted something like battery acid in the back of your throat, then you might have had acid reflux, also commonly known as heartburn.

You’re certainly not alone. In the United States, about 1 in 5 people have gastroesophageal reflux disease, or GERD, which is characterized by acid reflux and heartburn.

But what is acid reflux exactly? And what can you do about it?

What is Acid Reflux?

There’s a ringlike muscle where your esophagus meets your stomach called the lower esophageal sphincter (LES). A properly working LES protects the esophagus from the acid in your stomach by keeping the pathway between them clenched shut.

When the LES is loose or too relaxed, acidic gastric juices (the stuff in your stomach) can bubble up into your esophagus, which is a major cause of acid reflux. (Other causes include hiatal hernias, when part of the stomach pushes through the diaphragm.)

A little bit of reflux is normal. But if you have excessive stomach acid in your esophagus, you’re likely to be in a lot of discomfort.

“It’s very common,” says Naveen Narahari, MD, of REX Digestive Healthcare. “On any given week, 60 percent of the adult population might have some kind of reflux. But we look closely at patients who have symptoms frequently over the course of a week.”

“Three or more times a week is cause for concern,” adds Ruth Mokeba, MD, of REX Digestive Healthcare, “as well as high intensity of symptoms. We can help these patients improve their quality of life and hopefully reduce their chances of developing a more serious disease like Barrett’s esophagus or esophageal cancer.”

A complication of long-term GERD, Barrett’s esophagus changes a patient’s esophageal lining. This tissue damage leads to an increased risk of cancer.

Symptoms of Acid Reflux

If you have acid reflux, you might experience the following:

  • Burning sensation or discomfort in your chest
  • Burning sensation or discomfort in the back of your throat
  • Unpleasant taste in the back of your throat
  • Burping
  • Chronic cough
  • Unpleasant hiccups that seem to carry acid up your throat
  • Nausea
  • Problematic or painful swallowing
  • Throwing up

What Causes Acid Reflux?

When the LES becomes weakened or relaxed, it is less protective against gastric contents, which can flow backward into the esophagus. The most common culprits of acid reflux are lifestyle choices such as overeating, eating before bed or exercising immediately after a large meal. Other causes include:

  • Obesity
  • Too much alcohol or coffee
  • Acidic foods
  • Cigarettes
  • Certain drugs, especially blood pressure, anti-anxiety and pain medications
  • Hiatal hernia
  • Pregnancy

How to Treat Acid Reflux

If you see a doctor or a gastrointestinal specialist, he or she will determine what’s causing your discomfort and then decide how to treat it. Diagnostic tests might include an upper endoscopy, in which a long, flexible tube explores the esophagus (under sedation), or the esophageal pH test, an outpatient procedure in which the patient wears a small probe for 24 hours to detect the amount of acid being produced.

Once GERD is confirmed, treatments include lifestyle changes, medications and surgery.

Lifestyle changes:

  • Quit smoking
  • Lose weight
  • Wear looser clothes
  • Avoid food for a couple of hours before bedtime
  • Prop yourself up slightly to sleep instead of lying flat
  • Eat smaller meals
  • Stay upright for three hours after a meal

Medications:

  • Over-the-counter antacids to neutralize the acid in your stomach (such as Maalox, Mylanta and Rolaids)
  • Prescription antacids
  • H2 blockers that reduce the amount of acid your stomach makes (such as Zantac and Pepcid)
  • Proton-pump inhibitors that further reduce the amount of acid your stomach produces and are available both over the counter and by prescription (such as Prilosec, Nexium and Prevacid)
  • Prokinetics that help clear stomach contents and strengthen the LES (such as Reglan)

Other therapies:

  • Upper endoscopy, in addition to helping diagnose GERD, can be used to tighten the LES or fix a hiatal hernia
  • Fundoplication is a surgical procedure in which the upper part of the stomach is wrapped around the lower part of the esophagus to strengthen the LES

If you’re suffering from acid reflux, talk to your doctor about your options or find a doctor near you.

Acid Reflux infographic