Reflux and heartburn: causes, treatment and when to seek help
Reflux happens when stomach contents move back up into the oesophagus. This can cause heartburn, a burning sensation in the chest or upper abdomen, and sometimes regurgitation or a sour taste in the mouth.
Most reflux is manageable with lifestyle changes and short courses of medication, but ongoing symptoms should be reviewed to confirm the diagnosis and check for warning signs.
These articles are intended as educational sources, not diagnostic nor taking place of a proper medical assessment. If you need help, please book an appointment with one of our GP’s.
Symptoms of reflux and heartburn
Common symptoms include:
- Burning in the chest, often after meals or when lying down
- Sour taste or regurgitation
- Upper abdominal discomfort or indigestion
- A feeling of food coming back up
- Frequent burping
Some people get symptoms outside the chest area, such as:
- A chronic cough
- Hoarse voice or throat clearing
- A sensation of a lump in the throat
These symptoms can have other causes, so a GP review can help if they persist.
- Chest pain that could be cardiac, especially with breathlessness, sweating, nausea or pain spreading to the arm, jaw or back
- Difficulty swallowing or food sticking
- Pain on swallowing
- Vomiting blood or black stools
- Unintentional weight loss, persistent vomiting or progressive symptoms
Common causes and triggers
Reflux is often linked to how the valve at the bottom of the oesophagus works, and to pressure within the abdomen. Common triggers include:
- Large meals, late meals or lying down soon after eating
- Spicy or fatty foods
- Alcohol and caffeine
- Smoking
- Being overweight
- Pregnancy
- Certain medications, including some anti inflammatory medicines
Triggers are individual. A simple symptom diary can help identify patterns.
How a GP assesses reflux symptoms
A GP will usually ask about:
- Symptom pattern, frequency and duration
- Swallowing symptoms or pain on swallowing
- Weight loss, appetite changes, vomiting or bleeding
- Medication history and alcohol intake
- Risk factors such as smoking or family history
In many cases, reflux can be diagnosed based on typical symptoms and response to treatment. Investigations are considered if symptoms are persistent, severe, or atypical.
Investigations that may be considered
Most people do not need tests at the first presentation.
A GP may consider investigations if:
- Symptoms persist despite appropriate treatment
- There are red flag features
- Symptoms started later in life or have changed in character
- There are recurrent symptoms after stopping medication
Tests may include:
- Blood tests if there are signs of anaemia or weight loss
- Stool testing
- Referral for endoscopy to assess the oesophagus and stomach
- Less commonly, pH monitoring or specialist assessment
Self care for reflux
Simple changes often help:
- Eat smaller meals and avoid late meals
- Stay upright for 2 to 3 hours after eating
- Reduce trigger foods and drinks, one change at a time
- Aim for gradual weight loss if relevant
- Raise the head of the bed if night symptoms are frequent
- Stop smoking if applicable
If symptoms are occasional, antacids or alginate products may help in the short term.
GP treatments for reflux
Treatment is usually stepped:
- Short courses of acid suppression medication if symptoms are frequent
- Reviewing response and reducing to the lowest effective dose
- Considering longer term management if symptoms return repeatedly
Medication decisions should take into account symptom severity, personal risk factors and any warning signs.
When to seek GP review
Consider GP review if:
- Reflux symptoms occur more than a few times a week
- Symptoms wake you at night or persist beyond a few weeks
- Symptoms return quickly when medication is stopped
- You are unsure if symptoms are reflux or something else
- You have long term symptoms and want a treatment plan to reduce flare ups
Further Reading and Hub Links
Visit our Gut Health hub or browse more health topics in the AccessGP Knowledge Base.
If reflux or heartburn is ongoing, a GP can assess your symptoms, advise on treatment options and decide if further investigation is needed.
Last reviewed by Dr Zamiel Hussain, GMC registered GP
Updated: 3 January 2026