Acid Reflux and Heartburn: Causes, Remedies, and When to See a Doctor

What Is Acid Reflux?

Acid reflux occurs when stomach acid flows back up into the oesophagus (the tube connecting your mouth to your stomach). The burning sensation this causes in your chest is commonly known as heartburn.

Almost everyone experiences occasional heartburn — after a large meal, when lying down too soon after eating, or during pregnancy. But when it happens regularly (twice a week or more), it may be gastro-oesophageal reflux disease (GORD/GERD), which affects around 1 in 5 UK adults.

Common Causes

Dietary Triggers

• Spicy foods — chilli, curry, hot sauce
• Fatty or fried foods — slow gastric emptying
• Citrus fruits and tomatoes — acidic content
• Chocolate — relaxes the lower oesophageal sphincter
• Coffee and caffeine — stimulates acid production
• Alcohol — particularly red wine and spirits
• Carbonated drinks — increase stomach pressure

Lifestyle Factors

• Eating large meals — overfilling the stomach
• Eating close to bedtime — lying flat allows acid to travel upwards
• Being overweight — increases abdominal pressure
• Smoking — weakens the oesophageal sphincter
• Stress — doesn't directly cause reflux but worsens symptoms
• Tight clothing — pressure on the abdomen

Medical Causes

• Hiatal hernia — part of the stomach pushes through the diaphragm
• Pregnancy — hormonal changes and physical pressure
• Certain medications — NSAIDs, calcium channel blockers, some antidepressants

Home Remedies That Actually Help

1. Elevate the Head of Your Bed

Raising the head of your bed by 15-20cm (using blocks under the legs, not just extra pillows) is one of the most effective lifestyle changes. Gravity helps keep acid in the stomach.

2. Don't Eat Within 3 Hours of Bedtime

Give your stomach time to empty before lying down. This single change helps many people significantly.

3. Eat Smaller, More Frequent Meals

Large meals stretch the stomach and increase pressure on the lower oesophageal sphincter. Smaller portions reduce this effect.

4. Maintain a Healthy Weight

Even modest weight loss (5-10%) can significantly reduce reflux symptoms by decreasing abdominal pressure.

5. Identify Your Triggers

Keep a food diary for 2 weeks. Everyone's triggers are different — some people tolerate coffee fine but react to tomatoes, and vice versa.

Pharmacy Treatments

Antacids (Immediate Relief)

Antacids neutralise stomach acid and provide quick relief (within minutes). They're best for occasional, mild symptoms.

Alginates (Gaviscon)

Gaviscon Double Action combines an antacid with an alginate that forms a protective raft on top of stomach contents. This physical barrier prevents acid from rising into the oesophagus. It works within minutes and the effect lasts up to 4 hours.

This dual-action approach makes it more effective than antacids alone for reflux symptoms.

H2 Blockers (Ranitidine alternatives)

Since ranitidine was withdrawn, alternatives like famotidine reduce acid production for up to 12 hours. Available from pharmacies.

PPIs (Omeprazole, Lansoprazole)

Proton pump inhibitors are the most effective acid-reducing medications. Low-dose versions are available over the counter for short-term use (2 weeks). For longer use, you need a prescription.

When to See a Doctor

Most heartburn is harmless and manageable with lifestyle changes and pharmacy treatments. However, see your GP if you experience:

• Heartburn most days for 3 weeks or more
• Difficulty swallowing (dysphagia)
• Persistent vomiting
• Unintentional weight loss
• Blood in vomit or stools (may appear dark/tarry)
• Food getting stuck in your throat
• Symptoms not improving with over-the-counter treatment

These symptoms warrant investigation to rule out more serious conditions.

A Practical Approach

For most people, managing acid reflux is straightforward:

1. Identify and avoid triggers — keep a food diary
2. Lifestyle changes — smaller meals, don't eat late, elevate bed head
3. Gaviscon Double Action — for breakthrough symptoms
4. See your GP if symptoms persist despite these measures

Browse our Digestive Health range for Gaviscon and other pharmacy treatments.