Acid reflux: Causes, treatment, and symptoms

Acid reflux is a common condition that features a burning pain, known as heartburn, in the lower chest area. It happens when stomach acid flows back up into the food pipe.

Gastroesophageal reflux disease (GERD) is diagnosed when acid reflux occurs more than twice a week.

Exact figures vary, but diseases resulting from acid reflux are the most common gut complaint seen by hospital departments in the United States.

The American College of Gastroenterology says that over 60 million Americans experience heartburn at least once a month, and at least 15 million as often as daily.

GERD is most common in Western countries, affecting an estimated 20 to 30 percent of the population.

Chronic heartburn can lead to serious complications.

Fast facts on acid reflux

Here are some key points about acid reflux. More detail is in the main article.

Acid reflux is also known as heartburn, acid indigestion, or pyrosis.

It happens when some of the acidic stomach contents go back up into the esophagus.

Acid reflux creates a burning pain in the lower chest area, often after eating.

Lifestyle risk factors include obesity and smoking.

Drug treatments are the most common therapy and are available on prescription and over the counter (OTC).


Diagram of esophagus, stomach and digestive systemDiagram of the digestive system.

Acid reflux is when some of the acid content of the stomach flows up into the esophagus, into the gullet, which moves food down from the mouth. Despite the name, heartburn has nothing to do with the heart.

The stomach contains hydrochloric acid, a strong acid that helps break down food and protect against pathogens such as bacteria.

The lining of the stomach is specially adapted to protect it from the powerful acid, but the esophagus is not protected.

A ring of muscle, the gastroesophageal sphincter, normally acts as a valve that lets food into the stomach but not back up into the esophagus. When this valve fails, and stomach contents are regurgitated into the esophagus, the symptoms of acid reflux are felt, such as heartburn.

Risk factors

GERD affects people of all ages, sometimes for unknown reasons. Often, it is due to a lifestyle factor, but it can also be due to causes that cannot always be prevented.

One cause that is not preventable is a hiatal (or hiatus) hernia. A hole in the diaphragm allows the upper part of the stomach to enter the chest cavity, sometimes leading to GERD.

Other risk factors are more easily controlled:


smoking (active or passive)

low levels of physical exercise

medications, including drugs for asthma, calcium-channel blockers, antihistamines, painkillers, sedatives, and antidepressants

Pregnancy can also cause acid reflux due to extra pressure being placed on the internal organs.

Zantac - for heartburn relief
Zantac is one medication for heartburn relief.

The main treatment options for acid reflux are:

PPIs, including omeprazole, rabeprazole, and esomeprazole

H2 blockers, including cimetidine, ranitidine, and famotidine

Over-the-counter treatments, such as antacids, which are available to buy online.

Alginate drugs, including Gaviscon

The main treatment options for people who repeatedly experience acid reflux in GERD are either PPIs or H2 blockers, both of which are medications.

PPIs and H2 blockers decrease acid production and reduce the potential for damage caused by acid reflux.

These medications are generally safe and effective, but like any prescription drug, they are not appropriate for all people with reflux disease and can cause side effects.

For instance, they can cause problems absorbing nutrients. This can lead to malnutrition.

OTC remedies for acid reflux

For people who experience heartburn or indigestion infrequently, perhaps in association with occasional food and drink triggers, OTC treatments to reduce the acidity of the stomach contents are available.

These liquid and tablet formulations are called antacids, and there are dozens of brands available, all with similar effectiveness. They may not work for everyone, and any need for regular use should be discussed with a doctor.

Antacids provide rapid but short-term relief by reducing the acidity of the stomach contents.

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