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What Is Acid Reflux?

John J. Jones
John J. Jones

Acid reflux, also sometimes known as “heartburn,” is a common medical problem that happens when stomach acid creeps up into the esophagus. Sufferers often feel a burning sensation deep in their chest that may penetrate up their throat. The condition doesn’t actually involve the heart at all, though people often feel the most pressure right in that region of the chest. There are a couple of different causes, but most are related to diet; highly acidic foods are some of the worst culprits, as are foods that are particularly spicy or difficult to digest. Sometimes things like weight can also factor in, and those who are heavyset, obese, or pregnant are often most likely to suffer. Reflux that is persistent or that recurs frequently may be the result of a gastrointestinal disorder. Anyone who is worried about specific symptoms or issues is usually wise to talk with a qualified medical expert in order to get to the root of the problem.

Digestion Basics

An illustration of a human stomach. In acid reflux, stomach acid backs up from the stomach into the esophagus.
An illustration of a human stomach. In acid reflux, stomach acid backs up from the stomach into the esophagus.

Human digestion is a complex process that depends on a number of different moving parts. Food typically enters through the mouth, where the saliva begins to break it down; from there it travels down the throat, into the esophagus, and finally down into the stomach, where most of the churning and particulate breakdown happens. The stomach uses a lot of pretty harsh acids to separate food into its useful components, and they can hurt other more sensitive tissues. Most healthy people have a flap or valve known as the Lowe esophageal sphincter (LES) that keeps stomach acid out of the esophagus once digestion begins.

Spicy and tomato-based foods, like chili, can cause acid reflux.
Spicy and tomato-based foods, like chili, can cause acid reflux.

When the LES relaxes, food and acid can seep into the esophagus. The acid seepage in turn causes irritation or burning, which is collectively known as acid reflux. Though uncomfortable, the issue isn’t usually long-lasting. Secondary peristalsis, which is the movement of the esophagus caused by swallowing, pushes about 90% of the food and acid back into the stomach, usually within an hour or so. The LES closes again for normal digestion in most cases, and the remaining 10% of food and acid left in the esophagus is typically neutralized by saliva.

Main Causes of Reflux

People suffering from acid reflux should keep a diary of when symptoms occur.
People suffering from acid reflux should keep a diary of when symptoms occur.

Diet is the most common cause. Large meals, fatty or very spicy foods, and foods with naturally high acid contents can all be triggers, and things like meal timing can also factor in. People who eat large meals right before bed are often more likely to experience reflux, for instance, because the prone position usually makes digestion more challenging and can also make the LES closure more vulnerable. People who are overweight are sometimes also more at risk, and many pregnant women experience heartburn, particularly in the last trimester. An uneven weight distribution can put pressure on the stomach and can lead to increased acid leakage.

Recurring Problems and Conditions

Quitting smoking can reduce acid reflux.
Quitting smoking can reduce acid reflux.

In most cases reflux happens sporadically and doesn’t always have an identifiable root cause. For others, though, the problem can be more or less constant. Some sufferers experience heartburn after eating practically anything. In these cases, the condition is often part of a larger problem known as Gastroesophageal Reflux Disease (GERD).

GERD can be caused by many different factors. Some of the most common include transient LES relaxation, decreased LES resting tone, impaired esophageal clearance, delayed gastric emptying, decreased salivation, and impaired tissue resistance. It’s often the case that the problem stems from some inherited defect in the esophagus, though people who have suffered trauma and injury may also develop digestive problems as something of a side effect. p>

Treatment Options and Getting Relief

The hollow tube known as the esophagus runs from the stomach to the throat.
The hollow tube known as the esophagus runs from the stomach to the throat.

Curing acid reflux usually starts by determining what’s causing it. Taking a mild antacid is often effective, particularly for people whose reflux flares only sporadically. Many find that eating bland foods like plain bread or crackers after a meal can also prevent the worst symptoms. Those who primarily experience flare-ups at night can sometimes find relief by propping their beds slightly so as to elevate the torso and promote the downward movement of digestion; this particular remedy is commonly recommended for newborns, many of whom experience reflux in the first months of life before the esophagus fully develops.

Food and acid seeping into the esophagus can cause irritation and a burning sensation in the throat.
Food and acid seeping into the esophagus can cause irritation and a burning sensation in the throat.

GERD patients often find pharmaceutical regimens helpful, too. A number of different drugs have been developed to help calm acid regurgitation and promote proper digestive function. In extreme cases surgery to repair or strengthen the esophagus may also be recommended, but this is typically considered a last resort.

Millions of people suffer from acid reflux at night, making it difficult to get a good night's sleep. The best way to get a better night's sleep with acid reflux is by changing your sleep position. The best wedge pillows for acid reflux elevate the head and torso slightly above the rest of the body, encouraging gravity to keep stomach contents where they belong. A wedge pillow also provides support to the head and neck, which can help reduce acid reflux symptoms. The wedge pillow should be firm enough to provide this support but soft enough that it doesn't aggravate existing pain or discomfort.

Discussion Comments

anon960714

I think most acid reflux results from stress. Cultivate a stress free life. Make whatever changes you need to.

anon132061

Can you have acid reflux while sleeping? I have laryngitis and a nurse mentioned to me it could be from acid reflux. I have been drooling more in my sleep than ever before?

mutsy

Great article- I sometimes suffer from acid reflux. The condition worsens when I eat red tomato sauce later in the evening.

After experiencing this discomfort every time I ate something with red sauce, I just simply cut it out of my diet. I try to eat lighter meals in the evening and eat early enough so that my acid reflux does not flare up.

When my acid reflux does flare up I normally use Nexium if it is severe or Tums for milder flare ups. I try to modify my diet so that I won’t need these.

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    • An illustration of a human stomach. In acid reflux, stomach acid backs up from the stomach into the esophagus.
      By: pixologic
      An illustration of a human stomach. In acid reflux, stomach acid backs up from the stomach into the esophagus.
    • Spicy and tomato-based foods, like chili, can cause acid reflux.
      By: rafer76
      Spicy and tomato-based foods, like chili, can cause acid reflux.
    • People suffering from acid reflux should keep a diary of when symptoms occur.
      By: PicciaNeri
      People suffering from acid reflux should keep a diary of when symptoms occur.
    • Quitting smoking can reduce acid reflux.
      By: Minerva Studio
      Quitting smoking can reduce acid reflux.
    • The hollow tube known as the esophagus runs from the stomach to the throat.
      By: snapgalleria
      The hollow tube known as the esophagus runs from the stomach to the throat.
    • Food and acid seeping into the esophagus can cause irritation and a burning sensation in the throat.
      By: jedi-master
      Food and acid seeping into the esophagus can cause irritation and a burning sensation in the throat.