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What Causes Acid Reflux?

Image of What Causes Acid Reflux?
Image of What Causes Acid Reflux?

You’re flipping through the menu at one of your favorite restaurants, trying to choose something for lunch.

A grilled cheese with some creamy tomato bisque sounds perfect, but now you need to weigh the pros and cons. Yes, that steaming bowl of soup is delicious—but is it worth the hours you’ll spend popping antacids in agony?

If you’re someone who struggles with acid reflux disease, these sorts of decisions have become a staple of your everyday life.

And, here’s the thing: You aren’t alone in making them. According to the National Institute of Diabetes and Digestive and Kidney Diseases, 20% of Americans experience acid reflux symptoms on at least a weekly basis.

So, what exactly is acid reflux? Here’s the gist: It occurs when your stomach acid flows backward into your esophagus—the tube that connects your mouth to your stomach. That acid irritates the lining of your esophagus and causes a burning sensation (yep, you guessed it, heartburn).

You’ll also hear acid reflux referred to as gastroesophageal reflux disease (GERD), which is essentially the fancy name for acid reflux that occurs on a far more frequent basis (about once or twice per week).

But, what exactly causes acid reflux disease? And, even more importantly, what can you do to treat your symptoms—without being laid up on the couch for hours?

What causes acid reflux disease?

You know that acid reflux happens when your stomach acid essentially comes up the wrong way. But, why is this happening?

Most of us are quick to point the finger at different foods and beverages that trigger our raging heartburn (and those are definitely a factor), but first it’s important to understand what anatomical factors are at play.

Here’s what’s happening in your body

We all have something called a lower esophageal sphincter, which serves as the valve between the esophagus and the upper part of the stomach. When this muscle becomes weak or relaxes when it shouldn’t, it lets stomach acid move the wrong way and head back up into your esophagus.


As the National Institute of Diabetes and Digestive and Kidney Diseases explains, there are numerous factors that can contribute to the weakening or malfunction of this muscle, including:

  • Added pressure on your abdomen (from being overweight, obese, or pregnant)
  • Certain medications (such as antihistamines, painkillers, sedatives, antidepressants, calcium channel blockers, or medicines used to treat asthma)
  • Smoking or secondhand smoke

Yes, food plays a role here too

Here’s what you may be thinking now: But, what about the food? If this is all just an anatomical issue, why do I experience way more misery when I chug a glass of orange juice or eat too much cheese?

The foods that trigger heartburn can vary pretty greatly from person to person. However, there are some general rules of thumb for those that make heartburn worse.

Fatty foods, for example, sit in your stomach for longer periods of time. This means that your body needs to increase acid production in order to digest them, and the excess acid can come surging back up into your esophagus. Other foods that come up a lot are onion and garlic.

Large meals and carbonated beverages can also lead to heartburn hassle, as they fill up and stretch your stomach and put a lot of pressure on your lower esophageal sphincter. Coffee can also contribute to heartburn, as it’s been shown to weaken that sphincter while the caffeine stimulates increased acid production.

It’s not just coffee that can relax your esophageal sphincter, but also peppermint in all of its forms: tea, oil, and candies.

Finally, spicy foods or foods that are highly acidic (that includes anything from tomatoes to oranges) can add even more acid to your stomach contents and also irritate your esophageal lining.

Want to know what you should eat? Here’s an entire guide to the best acid reflux diet with recipes included.

Let’s talk about timing…

Even if you watch your diet carefully and avoid all of your triggers, heartburn can still strike without warning.

Timing might be to blame here—and no, we’re not talking about a full moon.

Many people experience worsening acid reflux symptoms at night, particularly when they’re laying down. When you’re standing, gravity helps to keep your stomach acid where it belongs: in your stomach. But, when you tuck yourself in for a night of restful sleep, you lose the advantage that gravity offers and that pesky acid can make a beeline for your esophagus.

Other people experience exacerbated symptoms when they’re under a lot of stress. And, while stress itself hasn’t been proven to actually cause acid reflux, it does contribute to an existing problem by increasing acid and pressure in the stomach.

What are the symptoms?

For better or for worse, acid reflux isn’t all that sneaky—it’s pretty uncomfortable and, as a result, easy to recognize. According to the Mayo Clinic, common symptoms include:

  • Burning sensation in your chest that may get worse at night
  • Chest pain
  • Difficulty swallowing
  • Feeling like you have a lump in your throat
  • Regurgitation of food or a sour-tasting liquid

To dig into the details of these symptoms (and even more), check out this helpful resource.

How is acid reflux disease diagnosed?

Diagnosing your acid reflux could be as simple as recognizi your doctor listening to your symptoms and history and conducting a brief consultation.

However, to formally confirm the diagnosis, the Mayo Clinic explains that you’ll need one of the following procedures:

Upper endoscopy: A thin tube containing a light and a camera (endoscope) is slid down your throat to examine your esophagus and stomach.

Ambulatory acid (pH) probe test: A monitor is placed in your esophagus and identifies when, and for how long, stomach acid is regurgitated. The monitor is connected to a small computer that you wear around your waist or over your shoulder.

Esophageal manometry: A pressure-sensitive tube is inserted down your esophagus and into your stomach to measure your muscle contractions and coordination when you swallow.

X-ray of your upper digestive system: After drinking a chalky liquid that allows your doctor to see the silhouette of your esophagus, stomach, and upper intestine, your doctor will conduct an x-ray.

Real talk: How serious is acid reflux disease?

You know that acid reflux disease is seriously uncomfortable, but exactly how serious is it in terms of medical conditions?

Here’s the good news: Acid reflux itself isn’t fun, but it also isn’t life-threatening. As long as you don’t leave it uncontrolled and untreated (don’t worry—we’ll discuss treatment options in the next section) the outlook isn’t dire.

Instead, it’s when you choose to ignore it and live with the discomfort that it becomes a larger problem. As the Cleveland Clinic explains, letting your acid reflux symptoms persist without any sort of intervention can lead to some pretty serious complications including:

Esophagitis: Erosions or ulcers in the esophagus as a result of constant exposure to stomach acid.

Barrett’s Esophagus: Repeated exposure to stomach acid can cause abnormal changes in the lining of the esophagus, in which normal cells are replaced with those that aren’t typically found in the esophagus. Barrett’s esophagus is a precancerous condition.

Strictures: Damaged areas of the esophagus can scar and lead to narrowing of that tube, which can lead to difficulty swallowing food.

Esophageal Cancer: Repeated exposure to acid reflux can lead to changes in the lining of the esophagus which over time can lead to a slightly increased risk of cancer of the esophagus.

While these sound serious — and they certainly are — they’re rare outcomes. For example, only 1 in 1,000 cases of Barrett's Esophagus evolve into esophageal cancer. That doesn’t mean you shouldn’t treat your acid reflux, but rather that you shouldn’t assume that a lack of treatment will automatically lead to cancer.

How can you treat or relieve your symptoms?

Don’t panic quite yet—as we mentioned, those are the worst-case scenarios if you leave your acid reflux disease totally untreated.

While acid reflux is a chronic condition and there’s no known cure, there are different options available to people who are struggling with any of the above-mentioned symptoms.


Because acid reflux is fairly common, there are plenty of medications that can help to lessen the severity of your symptoms. These medications can fall into the following categories:

Antacids: While these don’t do much in the way of treatment, they can help to reduce your discomfort in the moment by neutralizing your stomach acid.

H2 Blockers: These lower the amount of acid that your stomach releases while simultaneously protecting and healing your esophageal lining. You can take them for immediate relief and preventive care.

Proton Pump Inhibitors (PPIs): These types of medications actually block your body from producing acid while also healing and protecting your esophageal lining.

Some of these will be available as over-the-counter medications, while other stronger variations will require a prescription from a doctor.

Lifestyle changes

Medications can certainly help make living with acid reflux disease a little more comfortable, but there are also some lifestyle changes you can make to lessen or prevent your symptoms.

If you’re currently overweight or obese, you already know that focusing on weight loss will benefit your health in more ways than one. Yes, shedding those extra pounds requires some major changes and commitment and we’re not going to pretend it’s easy. But, here’s another perk to keep you motivated: Doing so can improve your acid reflux symptoms by reducing the pressure on your abdomen and your lower esophageal sphincter.

Similarly, eating smaller meals also reduces the amount of bloat and that full feeling you experience after eating a large meal—which decreases that pressure on your sphincter as well.

If you’re someone who experiences particularly terrible symptoms at night, you can try raising the head of your bed at least six inches using bricks, bed risers, or even a special wedge-shaped pillow. Doing so makes it that much tougher for your stomach acid to move backwards. In addition, try to minimize the amount of post-dinner snacking you do and try to sit upright for at least 2-3 hours before going to sleep.

This hopefully answered all of your burning questions about acid reflux disease. However, if you’re really struggling with heartburn, it’s important to talk with your doctor.

Your physician can listen to your triggers, your symptoms, and any lifestyle changes you’ve made, and use that information to help you identify a treatment plan that’s right for you.

Until then? It’s probably best to stay away from the tomato bisque that you know doesn’t agree with you, and opt for something else on the menu instead.

The information provided in this article is not a substitute for professional medical advice, diagnosis, or treatment. You should not rely upon the content provided in this article for specific medical advice. If you have any questions or concerns, please talk to your doctor.

This information should not be used to decide whether or not to take this medicine or any other medicine. Only your healthcare provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from your healthcare provider. You must talk with your healthcare provider for complete information about the risks and benefits of using this medicine.

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