Acid reflux and heartburn: what’s normal and when to get help

Gastro-oesophageal reflux disease (GORD), often referred to as acid reflux, is a common condition in which stomach acid flows back into the oesophagus (the tube that carries food from your mouth to your stomach). This can cause symptoms such as heartburn and an unpleasant taste in the mouth.

Acid reflux is one of the conditions we see most frequently in general practice, and it is important to understand what is normal, what may trigger symptoms, and when to seek advice.

What is acid reflux (GORD)?

GORD occurs when stomach contents flow back up into the oesophagus. The stomach is designed to hold acid, but the oesophagus is not. When acid reaches the oesophagus, it can irritate the lining, leading to the burning sensation commonly described as heartburn.

What symptoms should I look out for?

People experience reflux in different ways, but common symptoms include a burning or uncomfortable sensation in the chest or upper abdomen (heartburn), a sour or bitter taste in the mouth, and a feeling that food is sticking in the throat or chest. Some people also notice a sore throat or a persistent cough.

Symptoms often become more noticeable after eating or when lying down.

How common is it, and who is more likely to get it?

Acid reflux is very common, affecting around 10–15% of people. It can affect anyone, but certain factors can make it more likely. These include being overweight, smoking, drinking alcohol, and regularly consuming foods that are high in fat, sugar or salt. Caffeine can also trigger symptoms in some people.

Is acid reflux something to worry about?

For most people, reflux is a mild, manageable and episodic condition. However, if it occurs frequently or is left untreated, it can sometimes lead to complications. Ongoing irritation can cause inflammation of the oesophagus and, over time, may increase the risk of ulceration or changes to the lining.

One such change is known as Barrett’s oesophagus, which requires more frequent monitoring and specialist care.

Do I need tests to diagnose acid reflux?

In many cases, a diagnosis can be made based on symptoms alone, and treatment can begin without further investigation.

If symptoms are not improving with initial treatment, or if they are particularly severe or long-standing, your GP may recommend further tests.

What can I do to improve symptoms myself?

Lifestyle changes are often the first and most effective step in managing reflux. Maintaining a healthy weight can make a significant difference, as can identifying and avoiding foods that trigger your symptoms, such as fatty foods, coffee, chocolate or alcohol.

Eating smaller meals, avoiding late-night eating, and leaving at least three hours between your last meal and bedtime can also help. Some people benefit from raising the head of the bed slightly if symptoms are worse at night. Stopping smoking is also strongly recommended.

What treatments are available?

Many people start with over-the-counter remedies, which can provide short-term relief. These include antacids or alginate-based treatments such as Gaviscon, Rennie or Pepto-Bismol.

Other options include H2-receptor antagonists, which are often sold as indigestion or heartburn remedies, such as Pepcid.

If symptoms persist, your GP may prescribe a proton pump inhibitor (PPI), which is more effective at reducing stomach acid.

How do PPIs work and how should I take them?

PPIs work by reducing the amount of acid your stomach produces. They are typically taken once a day, around 30 to 60 minutes before a meal, and are usually prescribed for an initial course of four to eight weeks.

What happens after treatment starts?

If your symptoms improve, your GP will usually recommend reducing the dose to the lowest effective level or taking medication only when needed.

As reflux can be a long-term condition, symptoms may return when treatment is stopped, and some people require ongoing management.

What if my symptoms don’t improve?

If symptoms continue despite treatment, your GP may review how you are taking your medication or adjust the dose. In some cases, a different treatment may be tried.

If needed, you may be referred to a gastroenterologist for further investigation, which can include an endoscopy. In more severe or persistent cases, and particularly where complications such as Barrett’s oesophagus are present, surgical treatment may occasionally be considered.

What should I take away from this?

Acid reflux is very common and, in most cases, can be managed effectively with a combination of lifestyle changes and medication.

Recognising your symptoms early, understanding your triggers, and seeking advice promptly, particularly for symptoms that are more serious, persistent, or not responding to treatment, will help ensure safe and effective care.

If you are unsure about your symptoms or feel they are worsening, it is always sensible to speak to your GP.

If you would like to discuss acid reflux or any other digestive concern with one of our GPs, please get in touch. At Sloane Street Surgery in Chelsea, we offer private appointments at your convenience – book online or call us on 0207 245 9333.

Sources used:

Keung, C & Hebbard, G 2016, ‘The management of gastro-oesophageal reflux disease’, Australian Prescriber, vol. 39, no. 1, pp. 36-39.

National Institute for Health and Care Excellence (2015) Dyspepsia and gastro‑oesophageal reflux disease in adults. Quality standard [QS96]. London: National Institute for Health and Care Excellence. Available at: https://www.nice.org.uk/guidance/qs96

National Institute for Health and Care Excellence (2019) Gastro-oesophageal reflux disease and dyspepsia in adults: investigation and management. London: National Institute for Health and Care Excellence (NICE Guideline No. 184). Available at: https://www.nice.org.uk/guidance/cg184