What is reflux? Symptoms, causes, and treatment methods

Estimated reading time: 12 minutes 17 seconds

What is reflux? What complaints does it cause?

Reflux is a digestive system problem that occurs when stomach contents such as acid and bile flow back into the esophagus. Clinically, patients often present with complaints such as “my stomach burns,” “I feel something stuck in my throat,” or “bitter fluid comes into my mouth after eating.” Although these complaints are often interpreted as signs of reflux, not every episode of heartburn necessarily means reflux.

At this point, many readers may be wondering, “Is this just simple heartburn, or is it reflux?” In this article, while taking a closer look at reflux, we also aim to answer the questions you may have about this condition.

Before continuing with the topic of symptoms, it is important to add that complaints that recur frequently, wake a person from sleep at night, or affect eating habits should be evaluated by a specialist. The goal of reflux treatment is not only to suppress the complaint, but also to identify the underlying cause and create a suitable lifestyle, medication, or advanced treatment plan for the individual.

What are the symptoms of reflux?

Although reflux symptoms may vary from person to person, the most common symptoms are heartburn, a burning sensation in the chest, and bitter or sour fluid coming into the mouth. This picture is medically evaluated among gastroesophageal reflux symptoms. It usually becomes more noticeable after meals, when bending forward, when lying down, or at night.

In reflux, the burning sensation often starts behind the breastbone and may spread toward the throat. In addition, burping, bloating, indigestion, nausea, and a feeling of food getting stuck while swallowing may also occur. Therefore, the answer to the question “Can reflux cause nausea?” may be “yes,” depending on the situation.

Nausea may especially increase after meals. One of the frequently asked questions to physicians about reflux symptoms is “Does reflux cause gas?” Although reflux is not directly a gas-related disease, indigestion, burping, and bloating may accompany reflux.

Throat reflux symptoms and reflux cough

Reflux symptoms in the throat may not always occur together with heartburn. For this reason, some patients may experience throat complaints for a long time without realizing that they have reflux. The need to clear the throat, hoarseness, dry cough, a lump or stuck sensation in the throat, a bad taste in the mouth, a feeling of phlegm, and throat discomfort that increases especially in the morning may be seen in throat reflux. On the other hand, stomach acid reaching the esophagus and the throat area can irritate sensitive tissues and cause a dry and persistent cough.

What causes reflux?

As with many other diseases, more than one factor plays a role in the development of reflux. The main factors are usually insufficient function of the valve mechanism between the esophagus and the stomach, increased stomach pressure, and lifestyle-related factors. Normally, this valve prevents stomach contents from flowing back into the esophagus. However, when the valve relaxes or pressure on the stomach increases, stomach acid may move upward and cause complaints.

Hiatal hernia, excess weight, pregnancy, conditions that increase intra-abdominal pressure, eating late at night, eating quickly, consuming large portions, smoking, and alcohol use may increase the risk of reflux. Some medications may also affect the pressure of the valve between the esophagus and the stomach and make reflux complaints more noticeable. Therefore, reflux should not be considered only as “excess acid.” Anatomical structure, diet, weight status, medications used, and daily habits should be evaluated together.

What triggers reflux may vary from patient to patient. In some people, coffee may cause significant complaints, while in others, eating late at night or eating quickly may be more effective. Therefore, the most appropriate approach in reflux is for the person to recognize their own triggers and, if complaints become frequent, proceed with a physician’s evaluation.

Foods and habits that trigger reflux and those that may help with reflux

Foods and habits that may increase reflux complaints do not have the same effect on everyone. However, fried foods, fatty meals, chocolate, coffee, acidic beverages, alcohol, spicy foods, tomato-based foods, and acidic foods may trigger reflux in some people.

In addition, consuming large portions, eating quickly, lying down immediately after meals, and eating late at night may increase stomach pressure and make reflux complaints more noticeable.

When it comes to foods that are good for reflux, it would not be correct to talk about a single miracle food. In reflux, light, low-fat foods that do not strain the stomach and do not cause complaints in the individual are generally better tolerated. Frequently asked questions such as “Is yogurt good for reflux?” or “Is milk good for reflux?” should also be considered from this perspective; because there is no miracle food, and the answer may vary from person to person. For example, full-fat dairy products may provide short-term relief in some patients, while they may increase complaints in others. Therefore, the safest approach is to monitor personal triggers and consult a doctor in cases of persistent complaints.

What is good for reflux?

The aim in reflux is not only to temporarily reduce heartburn, but also to regulate habits that make it easier for stomach contents to flow back into the esophagus. Therefore, the most basic recommendations include eating smaller and more frequent meals, avoiding large portions, eating slowly, and stopping food intake at least 2–3 hours before bedtime.

Reviewing eating habits is one of the leading measures that may help with gastric reflux. However, every food does not have the same effect on everyone. For this reason, it is important for the person to monitor after which foods they experience burning, sourness, burping, or bitter fluid coming into the mouth.

In people with nighttime reflux, slightly elevating the head and upper body may be helpful. Instead of using only a high pillow, an inclined sleeping position that also supports the upper body may be more effective. Since excess weight can trigger reflux by increasing intra-abdominal pressure, weight control is also an important part of the treatment process.

In throat reflux, it is especially important not to eat late at night, not to lie down immediately after meals, to avoid smoking and alcohol, and to limit coffee and acidic drinks. If the need to clear the throat, hoarseness, and dry cough persist for a long time, not only reflux but also ear, nose, and throat diseases or allergic causes should be evaluated.

Caution should also be exercised regarding herbal teas that are said to be good for reflux and gastritis. Although some herbal teas such as chamomile, fennel, or ginger may provide relief in some people, these drinks do not replace reflux treatment. It should also be remembered that not every herbal tea is suitable for everyone. Pregnant women, people with chronic diseases, and those who regularly use medication should not consume herbal products without consulting a physician.

Is there an instant solution for reflux?

Symptoms such as burning in the chest, bitter fluid coming into the mouth, burning in the throat, burping, heartburn, or sudden discomfort can sometimes be quite disturbing. This leads people to search for an instant solution for reflux. Although these complaints are commonly referred to as a “reflux attack,” not every chest burning is caused by reflux. Therefore, the type of symptoms and accompanying findings should be carefully evaluated.

Lying down may make it easier for stomach contents to flow back into the esophagus and can increase complaints. If possible, the person should remain in a sitting position, loosen tight belts or clothing, and avoid consuming heavy and fatty foods. If your doctor has previously recommended reflux medications, they should be used as instructed. However, it should be underlined that unconscious medication use may not be appropriate, especially in people with heart, kidney, or liver disease, or in those who use regular medication.

How does reflux go away?

The goal of reflux treatment is not only to reduce heartburn for a short time, but also to control the factors that make it easier for stomach contents to flow back into the esophagus. Therefore, reflux treatment is often planned together with lifestyle changes, changes in eating habits, medication when necessary, and advanced evaluation in some patients.

The first step is usually regulating daily habits. Eating smaller and more frequent meals, avoiding large portions, stopping food intake 2–3 hours before bedtime, not lying down immediately after meals, avoiding excess weight, and observing foods that increase reflux may reduce complaints. In people with nighttime reflux, slightly elevating the head and upper body may also be helpful.

Medications used for reflux are not used in the same way for every patient. If the physician deems it necessary, they may benefit from medication groups aimed at reducing stomach acid, relieving the effect of acid, or controlling the escape of stomach contents into the esophagus. However, since the medication name, dose, and duration of use vary from person to person, unconscious medication use is not recommended. Especially in cases of long-lasting, frequently recurring complaints or complaints that return immediately after stopping medication, the underlying cause should be evaluated.

In some patients, the cause of reflux may be hiatal hernia, severe valve relaxation, or reflux that cannot be controlled despite medication treatment. In this case, advanced tests such as endoscopy and pH monitoring, and surgical options in selected patients, may come to the agenda. In short, there is no single standard treatment for reflux. The same medication or the same duration is not suitable for every episode of heartburn. The most appropriate approach is to create a personalized treatment plan with physician evaluation according to the duration and severity of the complaints.

Warnings and recommendations from Aktif International Hospital gastroenterology doctors

We spoke with our Gastroenterology doctors at Aktif International Hospital. We compiled their opinions and recommendations for you. Our doctors emphasize that in reflux complaints, it is important not only to focus on suppressing heartburn, but also to understand the cause of the complaint and its recurrence pattern. This is because reflux may be associated with many factors such as eating habits, weight status, hiatal hernia, medications used, sleep patterns, smoking and alcohol use, and stress.

It may make the diagnostic process easier for people with reflux complaints to note some details before the examination. The time of day when the burning increases, after which foods it becomes more noticeable, whether it wakes the person from sleep at night, whether bitter fluid comes into the mouth, and whether throat complaints such as cough or hoarseness accompany it should definitely be shared with the physician. Previously used stomach medications, how long these medications were used, and whether complaints returned after stopping the medication are also important for the treatment plan.

The same approach is not applied to every patient in a gastroenterology evaluation. While lifestyle changes may be sufficient in some patients, medication, endoscopy, or advanced tests may be required in others. However, one issue our doctors especially emphasize is this: If symptoms such as difficulty swallowing, painful swallowing, unintentional weight loss, anemia, bloody vomiting, black stools, persistent vomiting, or chest pain are present, a doctor should be consulted without delay.

Long-term unconscious medication use in reflux may cause different underlying diseases to be recognized late. Therefore, in reflux complaints that recur frequently, disturb sleep at night, or reduce quality of life, personalized evaluation should be performed and the treatment process should be planned under physician control.

Which doctor should you see for reflux?

For heartburn, bitter fluid coming into the mouth, burning in the chest, burping, and stomach complaints that increase after meals, the Gastroenterology department can usually be consulted. If reflux is accompanied by hiatal hernia, or if advanced evaluation or surgical options are required, the General Surgery department may also be included in the process.

If symptoms such as a stuck sensation in the throat, hoarseness, chronic cough, frequent need to clear the throat, or a feeling of phlegm are prominent among reflux complaints, an ear, nose, and throat evaluation may be necessary. If difficulty swallowing, unintentional weight loss, bleeding, persistent vomiting, or chest pain is present, a doctor should be consulted without delay.

Do reflux beds and reflux pillows work?

Reflux beds and reflux pillows may help reduce complaints in some people, especially those who experience nighttime reflux. The main aim here is to create a position that makes it more difficult for stomach contents to flow back into the esophagus while lying down. Slightly elevating the head and upper body may reduce complaints such as nighttime burning, bitter fluid coming into the mouth, and coughing in some patients.

However, placing several high pillows only under the head is not always effective. This position may cause neck and back pain. In addition, since the upper body is not elevated enough, it may not provide the expected benefit in reducing reflux. An inclined sleeping position that supports the upper body is a more effective solution. This incline can be achieved by raising the head of the bed or by using support products suitable for the individual.

Still, a reflux pillow or bed arrangement should not be seen as a treatment on its own. If nighttime reflux recurs frequently, wakes the person from sleep, or creates a need for medication, the underlying cause should be evaluated.

Reflux symptoms in babies and baby reflux beds

Reflux in babies may be common, especially in the first months. In newborns and young babies, since the valve mechanism between the stomach and the esophagus has not yet fully matured, a small amount of vomiting or milk coming back into the mouth after feeding may be seen. This does not always mean disease. If the baby is gaining weight well, feeding comfortably, and is in good general condition, it is often evaluated as physiological reflux.

Frequent vomiting, restlessness after feeding, crying, refusal to feed, coughing, wheezing, discomfort during sleep, and insufficient weight gain are among reflux symptoms. Feeding amount, feeding intervals, and the baby’s weight monitoring should be evaluated. If conditions such as bloody vomiting, bluish discoloration, respiratory distress, persistent cough, inability to feed, marked restlessness, or inability to gain weight are observed, a pediatrician should be consulted without delay.

Caution should be exercised regarding reflux beds used for babies. Due to safe sleep rules in babies, inclined beds, pillows, or positioning products should not be used without a doctor’s recommendation.

What are the symptoms of advanced reflux?

When reflux continues for a long time, irritation and sensitivity may develop in the esophagus, and narrowing may occur in some patients. In this case, difficulty swallowing, painful swallowing, a feeling that bites of food are getting stuck, persistent throat or chest pain, frequently recurring nighttime burning, and reflux attacks that wake the person from sleep may be seen.

If findings such as unintentional weight loss, anemia, bloody vomiting, black-colored stools, persistent vomiting, or marked difficulty while eating accompany reflux, it is not correct to wait for the symptoms to pass. Since these symptoms may also be signs of different digestive system diseases other than reflux, physician control is necessary.

When is reflux surgery necessary?

Reflux surgery is not a treatment method required for every reflux patient. However, in some patients, complaints may not be brought under control despite other preferred methods, or reflux may return shortly after stopping medication. In this case, surgical options may come to the agenda.

If symptoms continue despite medication and lifestyle changes, an evaluation with advanced tests may be necessary. Especially if reflux is accompanied by hiatal hernia, if findings such as irritation or narrowing in the esophagus have developed, or if the patient is not suitable for long-term medication use, reflux surgery may be considered as an option.

However, the most important point here is that the decision for surgery should not be made only based on the complaint. Not every episode of heartburn requires reflux surgery. The surgical decision should be made based on the patient’s complaints, endoscopy findings, the presence of hiatal hernia, and, if necessary, the results of pH monitoring and tests evaluating esophageal movements. In short, not every reflux patient is a surgical candidate, and selecting the right patient is decisive for treatment success.