What should you know about really bad acid reflux?

Acid reflux occurs when stomach contents move upward into the oesophagus. It can cause a burning sensation, sour taste, regurgitation, hoarseness or a cough, especially after meals or when lying down. A hiatus hernia can make reflux easier by changing the position of the stomach and the valve area. Reflux can disturb sleep and may sometimes feel like chest tightness, but chest symptoms should not automatically be attributed to reflux.

Try smaller meals, avoid lying down soon after eating and identify foods or drinks that reliably trigger symptoms. Raise the head end of the bed if night symptoms are prominent, and avoid tight clothing around the abdomen. If weight is contributing, a clinician can discuss supportive, sustainable changes without assuming a single cause. Keep a record of timing, meals, medicines and night waking. A GP can review whether an acid-reducing medicine or further assessment is appropriate.

Get urgent help for chest pressure or tightness with breathlessness, sweating, faintness, nausea or pain spreading to the arm or jaw. Arrange prompt assessment for difficulty swallowing, food sticking, vomiting blood, black stools, persistent vomiting, unexplained weight loss or severe abdominal pain. Book a consultation when symptoms are frequent, worsening, interrupt sleep or continue despite sensible measures.

Could these symptoms be reflux or another chest problem? Do I need a medicine review, testing or referral? Which warning signs should prompt urgent care?