Excessive acid reflux: what to know

Reflux may cause burning behind the breastbone, sour fluid in the throat, throat irritation, cough, chest tightness, or upper abdominal pain. Symptoms can worsen after a large meal, when bending, or when lying down. A hiatus hernia, excess body weight, some foods, alcohol, smoking, and certain medicines may contribute, but triggers vary. Frequent symptoms can disturb sleep and irritate the oesophagus or throat. Chest symptoms should not automatically be attributed to reflux because heart and lung problems can feel similar.

Try smaller meals and remain upright after eating. Notice personal triggers rather than removing broad food groups without a reason. Avoid eating close to bedtime if lying down brings symptoms, and raise the head end of the bed if a clinician recommends it. A pharmacist can discuss short-term relief; a clinician may consider acid reflux medication when symptoms recur. Take prescribed treatment as directed and report symptoms that continue despite it.

Book a review if reflux is frequent, affects sleep, causes ongoing cough, or makes swallowing painful or difficult. Seek urgent help for chest tightness or pain with breathlessness, sweating, fainting, or pain spreading to the arm or jaw; also seek urgent care for vomiting blood or black stools. Assessment may include a history, examination, and testing when symptoms or response to treatment warrant it.

Could my cough or chest symptoms have another cause? Which changes are most useful for my pattern? Do I need medication, testing, or review of another condition such as a hiatus hernia?