Ever woken up with a sour taste in your mouth? Acid Reflux might be to blame.

Gastroesophageal reflux also called "acid reflux" occurs when the stomach contents back up into the esophagus and/or mouth. Occasional reflux is normal and can happen in healthy infants, children, and adults, most often after eating a meal.

In contrast, people with gastroesophageal reflux disease (GERD) experience bothersome symptoms or damage to the esophagus as a result of acid reflux. Symptoms of GERD can include heartburn, regurgitation, and difficulty or pain with swallowing.

What happens in Acid Reflux and GERD?

When you eat, food is carried from your mouth to your stomach through the esophagus, a tube-like structure that is approximately 10 inches long and 1 inch wide in adults. The esophagus is made of tissue and muscle layers that expand and contract to propel food to your stomach through a series of wavelike movements called peristalsis.

At the lower end of the esophagus, where it connects to the stomach, there is a circular ring of muscle called the lower esophageal sphincter (LES). After you swallow, the LES relaxes to allow food to enter your stomach, where it mixes with acids that help with digestion. The LES then contracts to prevent the food and acid from backing up into your esophagus.

However, sometimes the LES relaxes inappropriately; this allows liquids in the stomach to wash back into the esophagus. This happens occasionally to everyone. Most of these episodes occur shortly after meals, are brief, and do not cause symptoms. Normally, reflux should rarely occur during sleep.

In some people, acid reflux causes bothersome symptoms or injury to the esophagus over time; when this happens, it is considered GERD. In general, damage to the esophagus is more likely to occur when acid refluxes frequently, the stomach contents are very acidic, or the esophagus is unable to clear away the acid quickly.

Risk Factors

Certain things increase a person's risk of developing GERD, including:

• Hiatus hernia – This is a condition in which part of the upper stomach pushes up through the diaphragm (the large, flat muscle at the base of the lungs). The diaphragm has an opening for the esophagus to pass through before it joins with the stomach (called the "diaphragmatic hiatus"); in people with a hiatal hernia, part of the stomach also squeezes up through this hole.
• Obesity – People who are obese or overweight seem to have an increased risk of GERD. While the reasons for this are not well understood, it is thought to be related to increased pressure in the abdomen.
• Pregnancy – Many women experience acid reflux during pregnancy. This usually resolves after delivery, and complications are rare.
• Lifestyle factors and medications – Some foods (including fatty foods, chocolate, and peppermint), caffeine, alcohol, and cigarette smoking can all cause acid reflux and GERD. Certain medications also increase the risk

Symptoms

The most common symptoms of GERD are:

• Heartburn – This typically feels like a burning sensation in the center of the chest, which sometimes spreads to the throat. It most often happens after a meal.
• Regurgitation – This is when stomach contents (acid mixed with bits of undigested food) flow back into your mouth or throat.

Other symptoms of GERD may include:

• Stomach pain (pain in the upper abdomen)
• Chest pain
• Difficulty swallowing (called dysphagia) or pain on swallowing (called odynophagia)
• Persistent laryngitis/hoarseness (due to the acid irritating the vocal cords)
• Persistent sore throat or cough
• Sense of a lump in the throat
• Nausea and/or vomiting

Nutrition & Prevention

Knowing what and when to eat can go a long way in preventing bothersome GERD flare-ups. 

• One significant culprit that can cause symptoms is fatty food. Try to choose lean meats, poultry, fish, tofu, and beans as protein sources. 
• Limit the amount of added butter and oil in your meals. Opt for baked dishes instead of fried foods. Pastries can be hidden sources of fat. Low-fat dairy is a great source of calcium and vitamin D that also may help prevent GERD symptoms when substituted for full-fat options.
• Certain foods and ingredients may worsen GERD symptoms. Mint, chocolate, alcohol, caffeine, acidic foods and spicy foods may trigger a flare-up.
• The timing and amount of food consumed also can make a difference in how you feel. Avoid large meals and opt instead for smaller, more frequent meals throughout the day.

Although we know the general triggers that can make GERD worse, customizing a lifestyle that works best for you can take some time. Try keeping a log of what you eat and drink throughout the day. 

Note when symptoms seem to flare up and review your log over time to identify patterns. Stay in contact with your doctor and a dietitian so they can help guide you to the best prevention and treatment strategies.

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