Acid reflux (also called heartburn or gastro-oesophageal reflux disease — GORD in the UK, GERD in the US) is one of the most common digestive conditions in the UK, affecting around 1 in 5 people. It occurs when stomach acid flows back up into the oesophagus (food pipe), causing a burning sensation in the chest or throat. While occasional heartburn is normal, frequent or severe acid reflux can significantly affect quality of life and lead to complications if left untreated.
Acid Reflux Symptoms
The most recognisable symptom of acid reflux is heartburn — a burning sensation in the chest, often behind the breastbone, that may worsen after eating, when lying down, or when bending over. Other common symptoms include an unpleasant sour or bitter taste in the mouth (acid regurgitation), difficulty swallowing (dysphagia), a feeling of food getting stuck in the throat or chest, an uncomfortable feeling of fullness after meals, persistent cough (particularly at night), hoarseness or a sore throat, excessive burping, nausea, and bad breath.
Symptoms of acid reflux often worsen after large meals, spicy or fatty foods, alcohol, coffee, citrus fruits, and chocolate, and when lying down within a few hours of eating.
What Causes Acid Reflux?
Acid reflux occurs when the lower oesophageal sphincter (LOS) — the muscular valve between the oesophagus and stomach — does not close properly, allowing stomach acid to escape upward. Several factors can weaken the LOS or increase pressure in the stomach, making reflux more likely. These include being overweight or obese, pregnancy, eating large meals or eating late at night, smoking, alcohol consumption, certain medications including NSAIDs (such as ibuprofen and aspirin), calcium channel blockers, and some antidepressants, a hiatus hernia (where part of the stomach pushes up through the diaphragm), stress and anxiety, and eating trigger foods.
GORD vs Occasional Heartburn: What Is the Difference?
Occasional heartburn (once a week or less) is very common and usually manageable with lifestyle changes and over-the-counter remedies. GORD (gastro-oesophageal reflux disease) is diagnosed when reflux symptoms occur frequently (twice a week or more), are severe, or are causing complications. GORD requires medical assessment and may need prescription treatment. See your GP if you experience heartburn more than twice a week, if over-the-counter antacids stop working, if you have difficulty swallowing, unexplained weight loss, or persistent vomiting.
When Is Acid Reflux an Emergency?
Seek urgent medical attention if you experience severe chest pain (always rule out a heart attack first — call 999 if in doubt), vomiting blood or material that looks like coffee grounds, black or tarry stools, difficulty swallowing that is getting worse, significant unexplained weight loss, or anaemia. These symptoms may indicate a more serious condition such as a bleeding ulcer or oesophageal cancer.
NHS Treatment for Acid Reflux
NHS treatment for acid reflux starts with lifestyle modifications and over-the-counter medications. Antacids (such as Gaviscon, Rennie, and Tums) provide rapid relief by neutralising stomach acid and are available without prescription from pharmacies. H2 receptor antagonists (H2 blockers) such as ranitidine (now withdrawn) and famotidine reduce acid production and provide longer relief. Proton pump inhibitors (PPIs) such as omeprazole and lansoprazole are the most effective medications for frequent acid reflux and GORD and are available on prescription from your GP. Low-dose PPIs such as omeprazole 10mg are also available over the counter from pharmacies without a prescription.
For people with severe GORD that does not respond to medication, surgical options are available on the NHS. The most common procedure is laparoscopic Nissen fundoplication, where the top of the stomach is wrapped around the lower oesophagus to strengthen the sphincter.
Lifestyle Changes to Reduce Acid Reflux
Lifestyle changes are highly effective for managing acid reflux and should be the first approach. Losing weight if overweight has been shown to significantly reduce reflux symptoms. Eating smaller meals more frequently rather than large meals puts less pressure on the stomach. Avoiding eating within two to three hours of bedtime prevents lying down with a full stomach. Elevating the head of the bed by 15–20cm using bed blocks (not extra pillows) can reduce night-time reflux. Stopping smoking, as smoking relaxes the LOS and reduces saliva production which neutralises acid. Reducing alcohol, particularly wine, beer, and spirits. Identifying and avoiding personal trigger foods, which commonly include spicy foods, fried and fatty foods, citrus fruits, chocolate, coffee, mint, and onions. Wearing loose-fitting clothing around the waist reduces pressure on the stomach.
Acid Reflux During Pregnancy
Heartburn and acid reflux are extremely common during pregnancy, particularly in the third trimester, affecting up to 80% of pregnant women. The pregnancy hormone progesterone relaxes the LOS, and the growing uterus puts upward pressure on the stomach. Lifestyle measures and antacids that are safe in pregnancy (such as Gaviscon) are typically tried first. Always check with your midwife or GP before taking any medication during pregnancy.
Barrett’s Oesophagus and Long-Term Complications
Chronic, untreated acid reflux can damage the lining of the oesophagus over time. In some people this leads to a condition called Barrett’s oesophagus, where the cells lining the lower oesophagus change to resemble those of the intestine. Barrett’s oesophagus itself is not cancerous, but it carries a small increased risk of developing oesophageal adenocarcinoma (a type of oesophageal cancer). People with Barrett’s oesophagus are offered regular surveillance endoscopies on the NHS to monitor for any precancerous changes.
Important: The information on this page is for educational purposes only. If you are experiencing frequent or severe acid reflux symptoms, please see your GP for assessment and personalised treatment advice.
Related Health Guides on YourHealthXpert
Explore these related NHS-aligned health guides on conditions connected to this topic:
- IBS (Irritable Bowel Syndrome) — acid reflux and IBS frequently coexist; functional GI conditions often overlap
- Asthma — GORD is a common and overlooked asthma trigger
- Anxiety and Depression — stress and anxiety worsen acid reflux symptoms
- Weight Loss — obesity is a key driver of GORD; weight loss can resolve symptoms