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What is acid reflux? Signs, symptoms and when to seek help

In this blog, Professor Ahmed Ahmed, Consultant GI and Bariatric Surgeon, explains what acid reflux is, the symptoms to look out for and when it may be time to seek specialist advice.

3 November 2026

If you've ever experienced a burning sensation in your chest after a meal, a sour taste in your mouth or discomfort when lying down, you may have experienced acid reflux.

Acid reflux is a common condition that affects millions of people worldwide. While occasional symptoms are usually nothing to worry about, frequent or persistent reflux can have a significant impact on quality of life and may require medical assessment.

In this blog, Professor Ahmed Ahmed, Consultant GI and Bariatric Surgeon, explains what acid reflux is, the symptoms to look out for and when it may be time to seek specialist advice.

What is acid reflux?

Acid reflux occurs when stomach acid travels back up into the oesophagus (food pipe). Normally, a ring of muscle at the bottom of the oesophagus, known as the lower oesophageal sphincter, acts as a valve to keep stomach contents where they belong.

When this valve becomes weakened or relaxes at inappropriate times, stomach acid can flow backwards into the oesophagus, causing irritation and discomfort.

Occasional reflux is common and can happen after large meals or certain foods. However, when symptoms occur regularly, it may be a sign of gastro-oesophageal reflux disease (GORD), a longer-term condition that often requires treatment.

What are the symptoms of acid reflux?

Symptoms can vary from person to person, but common signs of acid reflux include:

A burning sensation in the chest (heartburn)
A sour or acidic taste in the mouth
Regurgitation of food or liquid
Difficulty swallowing
A feeling of food sticking in the throat or chest
Persistent cough
Hoarseness or a sore throat
Frequent throat clearing
Bad breath
Symptoms that worsen after eating or when lying down

Some people experience reflux symptoms mainly at night, which can disturb sleep and lead to ongoing fatigue.

What causes acid reflux?

Several factors can increase the risk of developing acid reflux, including:

Being overweight

Excess weight increases pressure within the abdomen, making reflux more likely.

Diet and lifestyle factors

Certain foods and drinks can trigger symptoms, including:

Fatty or fried foods
Spicy foods
Chocolate
Caffeine
Alcohol
Fizzy drinks

Large meals and eating late in the evening can also worsen symptoms.

Hiatus hernia

A hiatus hernia occurs when part of the stomach moves upwards through the diaphragm. This can weaken the body's natural anti-reflux mechanisms and contribute to ongoing reflux symptoms.

Pregnancy

Hormonal changes and increased abdominal pressure during pregnancy can make reflux more common.

Smoking

Smoking can weaken the lower oesophageal sphincter, increasing the risk of acid reflux.

How is acid reflux diagnosed?

For many people, acid reflux can initially be diagnosed based on symptoms alone.

However, if symptoms are severe, persistent or not responding to treatment, further investigations may be recommended.

These can include:

Endoscopy

An endoscopy uses a thin flexible camera to examine the oesophagus and stomach, helping identify inflammation, ulcers or other abnormalities.

pH monitoring / Bravo capsule

This test measures acid levels in the oesophagus over 24 hours to determine the frequency and severity of reflux episodes.

Oesophageal manometry

This assesses how well the muscles of the oesophagus are functioning and can be useful when considering treatment options.

Barium Meal X-ray

This provides images of the anatomical relationships between the stomach, oesophagus and the diaphragm and is an accurate way to find a hiatus hernia as well as see live / ongoing reflux during real time image / video capture.

How is acid reflux treated?

Treatment depends on the severity of symptoms and the underlying cause.

Lifestyle changes

Many people find their symptoms improve by:

Maintaining a healthy weight
Avoiding trigger foods
Eating smaller meals
Avoiding eating close to bedtime
Raising the head of the bed
Reducing alcohol intake
Stopping smoking

Medication

Medications such as proton pump inhibitors (PPIs) work by reducing stomach acid production and are often highly effective in controlling symptoms. There has however been recent reports about long-term side effects from using these medications.

Surgical treatment

For some patients, particularly those with significant reflux or a hiatus hernia, surgery may be an option.

Anti-reflux surgery aims to strengthen the barrier between the stomach and oesophagus, helping to prevent acid from travelling upwards. Surgery may also allow patients to stop long-term medication.

A specialist assessment can help determine whether surgical treatment is appropriate.

When should you seek medical advice?

While occasional acid reflux is common, you should seek medical attention if you experience:

Symptoms more than twice a week
Symptoms that persist despite medication or if you do not wish to take long-term antiacid medicines
Difficulty swallowing
Unexplained weight loss
Recurrent vomiting
Chest pain
Symptoms that are affecting your sleep or quality of life

Expert care for acid reflux at Cromwell Hospital

At Cromwell Hospital, our specialist consultants provide comprehensive assessment, diagnosis and treatment for acid reflux, GORD and hiatus hernia.

Patients have access to rapid diagnostics, expert gastroenterologists and surgeons, and personalised treatment plans tailored to their individual needs.

If acid reflux is affecting your daily life, seeking specialist advice can help identify the cause and provide effective long-term relief.

About the author

Professor Ahmed Ahmed is a Consultant GI and Bariatric Surgeon at Cromwell Hospital and an Associate Professor of Surgery at Imperial College London. He specialises in upper gastrointestinal conditions, including acid reflux, hiatus hernia and weight-related disorders, with particular expertise in laparoscopic (keyhole) and minimally invasive surgery. Professor Ahmed is a leading authority in bariatric and metabolic surgery and serves as President of the British Obesity and Metabolic Specialist Society (BOMSS). He is committed to delivering personalised, evidence-based care, helping patients achieve the best possible outcomes through both surgical and non-surgical treatments.