Acid Reflux: Understanding Causes and Treatment Options

June 5, 2024

Understanding Acid Reflux

Acid reflux occurs when stomach acid or bile flows back into the esophagus, the tube connecting your mouth and stomach. This backwash, known as reflux, can irritate the lining of your esophagus and cause a burning sensation in your chest (heartburn). When acid reflux occurs frequently, it may be diagnosed as gastroesophageal reflux disease (GERD).

Causes of Acid Reflux

Several factors can contribute to the occurrence of acid reflux:

Dysfunction of the Lower Esophageal Sphincter (LES)

  • Weak LES: The LES is a ring of muscle at the entrance to the stomach. It acts as a valve, opening to let food into the stomach and closing to prevent stomach acids from escaping back into the esophagus. If the LES is weak or relaxes inappropriately, acid can reflux into the esophagus.
  • Hiatal Hernia: This condition occurs when the upper part of the stomach bulges through the diaphragm into the chest cavity. The diaphragm normally helps keep acid in the stomach, but a hiatal hernia can weaken this barrier and cause acid reflux.

Dietary and Lifestyle Factors

  • Certain Foods and Beverages: Consuming large meals or lying down right after eating can trigger reflux. Specific foods and drinks that are known to increase acid reflux include spicy foods, citrus fruits, tomato-based products, fatty or fried foods, chocolate, caffeine, and alcohol.
  • Obesity: Excess body weight can put pressure on the abdomen, pushing up the stomach and causing acid to back up into the esophagus.
  • Smoking: Smoking can weaken the LES and increase acid production in the stomach.
  • Pregnancy: Hormonal changes during pregnancy can cause the LES to relax, and the growing fetus can increase pressure on the stomach, leading to acid reflux.

Medications and Medical Conditions

  • Certain Medications: Some medications, such as aspirin, ibuprofen, certain muscle relaxers, and blood pressure medications, can contribute to acid reflux.
  • Gastroparesis: A condition in which the stomach takes longer to empty, which can increase the likelihood of acid reflux.
  • Connective Tissue Disorders: Conditions such as scleroderma can cause acid reflux by affecting the esophagus and LES.

Symptoms of Acid Reflux

The symptoms of acid reflux can vary from mild to severe and include:

  • Heartburn: A burning sensation in the chest, usually after eating, which might be worse at night or when lying down.
  • Regurgitation: A sour or bitter-tasting acid backing up into your throat or mouth.
  • Difficulty Swallowing (Dysphagia): A sensation of food being stuck in the throat.
  • Chronic Cough: Persistent coughing is not linked to respiratory conditions.
  • Hoarseness or Sore Throat: Irritation caused by acid.
  • Lump in Throat Sensation: A feeling of a lump in the throat without an actual lump present.

Treatment Options for Acid Reflux

Effective management of acid reflux typically involves lifestyle changes, dietary adjustments, medications, and, in severe cases, surgical interventions.

Lifestyle and Dietary Changes

  • Avoid Trigger Foods: Identifying and avoiding foods and beverages that trigger reflux can help reduce symptoms.
  • Eat Smaller Meals: Consuming smaller, more frequent meals can prevent the stomach from becoming too full and reduce pressure on the LES.
  • Avoid Lying Down After Eating: Wait at least two to three hours after eating before lying down or going to bed to allow time for digestion.
  • Elevate the Head of Your Bed: Raising the head of your bed by about 6 to 8 inches can help prevent acid from flowing back into the esophagus while sleeping.
  • Maintain a Healthy Weight: Losing excess weight can reduce pressure on the abdomen and decrease the frequency of acid reflux.
  • Quit Smoking: Smoking cessation can improve LES function and reduce acid production.
  • Wear Loose-Fitting Clothing: Tight clothes can put pressure on the abdomen and the LES, exacerbating reflux symptoms.


  • Antacids: Over-the-counter antacids, such as calcium carbonate (Tums), can provide quick relief by neutralizing stomach acid.
  • H2 Blockers: Medications like ranitidine (Zantac) and famotidine (Pepcid) reduce the amount of acid produced by the stomach and provide longer-lasting relief.
  • Proton Pump Inhibitors (PPIs): Medications such as omeprazole (Prilosec) and esomeprazole (Nexium) block acid production and allow time for damaged esophageal tissue to heal. PPIs are often used for more severe cases of acid reflux.
  • Prokinetics: These medications help strengthen the LES and speed up stomach emptying, reducing the likelihood of acid reflux.

Surgical Treatments

  • Fundoplication: This surgical procedure involves wrapping the top of the stomach around the LES to strengthen it and prevent reflux. It can be performed laparoscopically with minimal invasion.
  • LINX Device: A ring of tiny magnetic beads is wrapped around the LES to strengthen it. The magnetic attraction between the beads helps keep the LES closed while still allowing food to pass through.

When to See a Doctor

If you experience acid reflux symptoms more than twice a week or if they significantly interfere with your daily life, it may be time to see a healthcare professional. Persistent acid reflux can lead to complications such as esophagitis, esophageal strictures, or Barrett’s esophagus, which increases the risk of developing esophageal cancer. If you have difficulty swallowing, unexplained weight loss, or persistent chest pain, these could be signs of more severe conditions and should not be ignored. Early diagnosis and treatment of acid reflux can help prevent long-term complications and improve your quality of life.


Acid reflux is a common condition that can often be managed effectively with lifestyle changes, dietary adjustments, and medications. Understanding the causes and symptoms of acid reflux is crucial for developing an effective treatment plan. In severe cases, surgical options may be considered. If you experience frequent or severe acid reflux, it is important to consult with a healthcare provider to develop a comprehensive management plan and prevent potential complications.