As you’ll learn, there are many common causes of GERD and acid reflux, which include pregnancy, hiatal hernias, eating an unhealthy diet and an imbalance of stomach acid. All of these can result in the regurgitation of acid that triggers unpleasant acid reflux symptoms, such as burning or belching.

At the root of acid reflux is dysfunction of the the lower esophageal sphincter, which is supposed to close as soon as food passes through. However, if it doesn’t close all the way, acid can creep up from lower in the digestive system and begin to cause an array of problems. If it’s not treated properly, long-term acid reflux can cause severe damage.

Easing acid reflux or GERD symptoms temporarily with medications or over-the-counter drugs is usually not a cure — it’s only a way to offer some relief as symptoms are suppressed in the short-term. Ironically, these medications may cause new or worsened symptoms, depending on how your body reacts to them. If you’ve been relying on over-the-counter and/or prescriptions to ease pain and discomfort, you might be familiar with some of the notorious side effects associated with their use, which include headaches, muscle cramps, rapid heart rate and more digestive upset.

Below you’ll find information related to natural remedies for managing acid reflux symptoms, providing you with a much better understanding overall of what causes this type of digestive dysfunction to begin with and how it can finally come to an end. In addition to lowering acid reflux symptoms, the same types of treatments can also usually be helpful for managing related issues, such as GERD symptoms.

Acid Reflux Symptoms and Complications

The most common acid reflux and GERD symptoms include:

Heartburn

Bitter taste in your mouth, periodically or (for some people) throughout the day (some people taste regurgitated food or sour liquid at the back of their mouths/throats)

Waking up in the middle of the night feeling like you’re choking or coughing

Dry mouth

Gum irritation, including tenderness and bleeding

Bad breath

Regurgitation of acidic foods

Bloating after meals and during bouts of symptoms

Nausea

Bloody vomiting (possible sign of damage in the lining of the esophagus)

Black stools

Belching, gassiness, burping and flatulence after meals

Hiccups that are difficult to stop

Difficulty swallowing (a possible sign of narrowing esophagus)

Unexpected weight loss

Increased discomfort when bending over or lying down

Hoarseness upon waking or throughout the day

Chronic throat irritation, soreness and dryness

Acid Reflux Complications

If you experience ongoing regurgitation of acid — because you don’t respond well to medications or don’t take steps to treat the root causes, for examples — scarring of tissue in the lower esophagus can result in narrowing of the esophagus, which raises the risk for other problems. Research shows that long-term complications associated with untreated symptoms of acid reflux include Barrett’s esophagus (a serious complication of GERD), cancer of the esophagus, sleep-related problems and chronic coughs.

As the rate of acid reflux has risen steadily over the past decade, so have related complications. The American Cancer Society estimates that in 2017, nearly 17,000 new cases of esophageal cancer were diagnosed in the U.S. and almost 16,000 Americans died of the disease. There are also side effects and complications possible due to taking medications for acid reflux, including prescription and even over-the-counter drugs. I’ll touch on that shortly.

Causes and Risk Factors of Acid Reflux Symptoms

Contrary to popular belief (and what many pharmaceutical companies say in advertisements), acid reflux symptoms are not caused by too much acid in the stomach. In fact, it is now believed by many that low stomach acid often causes symptoms.

Acid reflux is caused by acid rising up to the esophagus, the tube that connects the throat and stomach. Acid enters the esophagus because of a leaky valve, and there are a variety of reasons this happens. The esophageal valve that connects the esophagus and stomach is unable to shut properly and gastric juices end up “sneaking up the pipe.” Then without proper levels of acid in the stomach, digestion is altered, often causing unpleasant symptoms.

While everyone’s gut is different and we all have different food sensitivities as well as acid reflux triggers, there are some repeat offenders that seem to contribute to many cases of acid reflux or GERD.

Causes and risk factors associated with acid reflux and GERD include:

Inflammation: Studies have found that high levels of inflammation are linked to the development of GERD because they cause tissue damage and dysfunction in the esophagus. Inflammation left to fester is also a factor in the development of esophageal cancer, a known complication of acid reflux.

Hiatal Hernia: Hiatal hernias can cause the unpleasant symptoms of acid reflux. The diaphragm helps separate the stomach from the chest. A hiatal hernia happens when the upper part of the stomach protrudes above the diaphragm, allowing acid to escape. These hernias are associated with most, but not all, cases of GERD.

Carbohydrate malabsorption: More and more evidence seems to point to the link between the poor digestion of carbohydrates and GERD. In the book “Heartburn Cured,” Dr. Norm Robillard argues that we target some incorrect trigger foods when treating GERD nutritionally and that more focus should be on eliminating excess carbohydrates.

The mechanisms behind this are somewhat complex, but to sum it up: research seems to reflect that acid reflux and GERD are probably exacerbated by too much intra-abdominal pressure (gas throughout the intestines). Robillard and other sources believe this pressure is the result of bacterial overgrowth, such as SIBO, and malabsorption of carbohydrates. The root of this pressure may ultimately trace back to the low stomach acid of those suffering from acid reflux.

Underdeveloped digestive system: Babies can develop acid reflux or GERD due to an underdeveloped digestive system. GERD in babies usually self-corrects by the age of 1.

Aging: Many aging and elderly members of the American population lack the appropriate amount of stomach acid needed to digest their food fully, often considered a side effect of taking antacids regularly and/or malnutrition. This is true especially for those older inpiduals with H. pylori infections, which ultimately leads to atrophic gastritis, an inflammation of the gastric mucosa within the stomach.

One complication of acid reflux and GERD in elderly patients is that their symptoms present differently than younger people suffering the same issues. Repeated reflux eventually leads to an inability to recognize the severity of acid in the esophagus, which is why some older people don’t recognize symptoms of acid reflux, although they may be suffering from serious complications like erosive esophagitis or Barrett’s esophagus. It is not uncommon for doctors to find that GERD is the root cause of serious symptoms in the elderly like chest pain, other heart symptoms and gastrointestinal bleeding.

Pregnancy: When a woman is pregnant, the fetus can put extra pressure on the esophageal valve, causing the release of acid and symptoms of acid reflux. Elevating the head during sleep, sipping herbal teas and eating smaller meals can help.

Obesity: Being overweight or obese can put extra pressure on the valves and sphincter that allow release of acid. This is probably why obesity is often associated with acid reflux and GERD. In eight out of nine studies included in a large review, as BMI (body mass index, a measure of body fat) rose, so did GERD symptoms. The same study review found that obesity was correlated with higher levels of other related disorders, including erosive esophagitis, esophageal and gastric cancers.

Large meals: Eating bigger meals is a culprit, as is snacking too close to bedtime. An overly full stomach places excessive pressure on the diaphragm, causing acid to travel upward.

Smoking cigarettes: This impairs muscle reflexes and increases production of acid, and it should be avoided for anyone suffering from acid reflux. Smoking cessation is associated with significant improvement of GERD/acid reflux symptoms.

Medications and supplements: Certain medications, including ibuprofen, muscle relaxers, some blood pressure prescriptions, antibiotics and aspirin can cause acid reflux and GERD. Potassium and iron supplements can also aggravate reflux symptoms. Read warning labels, and discuss alternatives with your physician.

Heartburn: Heartburn can be the first symptom of an H. pylori infection that’s common in two-thirds of the population and tied to stomach ulcers. Left untreated, severe infection can sometimes contribute to formation of stomach cancer.

Excessive exercise: Due to taxing the nervous system, overtraining and getting too little rest can cause acid reflux by putting extra pressure on the abdominal cavity. This includes running and other aerobic high-impact exercises.

Magnesium deficiency: Low magnesium levels may lead to improper functioning of the sphincter that prevents acid from escaping.

Chronic cough: There is a strong correlation between cough and acid reflux. Although this relationship is not causal (meaning researchers have not definitely proven one causes the other), cough may be either a factor in developing GERD or a symptom of the process of acid escaping into the esophagus.

Acid Reflux vs. GERD vs. Heartburn: How Are They Different?

All of these painful digestive conditions are related and tend to cause similar symptoms; however, they usually develop in stages.

In the case of acid reflux, the patient experiences backward flow of stomach acid into the esophagus. When this progresses, it can be diagnosed as GERD, which is considered to be more severe.

Heartburn is also commonly called GERD. The most common symptom of GERD is frequent pains in the chest and burning sensations (hence the name “heartburn”). Other signs of GERD are difficulty swallowing or keeping down food/liquids (very common in young children), coughing, wheezing and chest pain. Most often these symptoms occur at night.

It’s estimated that 60 percent of Americans have heartburn at least once a year, with 20–30 percent suffering at least once a week. An alarming finding is that the prevalence of weekly heartburn and other symptoms of acid reflux rose nearly 50 percent over the last decade. Findings from one study conducted over 11 years in Norway found that the incidence of acid reflux rose from around 11 percent of the population to over 17 percent within this time period, and a similar rise has happened in the U.S. and other industrialized countries too.

Precautions Regarding Acid Reflux Symptoms

If your acid reflux symptoms interfere with your lifestyle or daily activity and last for more than two weeks, then consider visiting a doctor. Other reasons to get a professional opinion on treatment options include experiencing hoarseness; worsening of asthma after meals; pain that’s persistent when lying down; pain following exercise; difficulty breathing that occurs mainly at night; and trouble swallowing for more than one to two days.

To determine a diagnosis of GERD, doctors may perform an endoscopy, a procedure involving a small tube inserted into the throat to look at the condition of the esophagus, stomach and small intestine. Some evidence indicates that an endoscopy may not be as effective as previously hoped, but it is still a common practice.

Another method of detecting acid reflux/GERD when a patient complains of acid reflux symptoms is the barium swallow test. A barium solution is ingested, allowing for internal X-rays to locate esophageal changes. Unfortunately, only 1 out of 3 GERD patients have noticeable esophageal changes that can be seen on a barium swallow X-ray.

One more diagnostic is a stomach acid test in which the stomach contents are emptied and gastrin is injected into the body to determine acid secretion.

If you are concerned you may have low stomach acid, most doctors will not recommend testing (because low stomach acid isn’t the traditionally accepted cause of acid reflux symptoms), but you can personally ask for a Heidelberg test./.

( Kathleen McCoy )