Acid Reflux (GORD / GERD)

Medically written by
A/Prof Viraj Kariyawasam
MBBS, FRACP, MRCP, PhD
Gastroenterologist & Hepatologist
Associate Professor – Macquarie University
Head of IBD Service – Blacktown Hospital
Last reviewed: March 2026

What is acid reflux?

Acid reflux happens when stomach acid flows back into the oesophagus, which is the tube that
carries food from your mouth to your stomach.

This can happen if the lower oesophageal sphincter, a ring of muscle between the oesophagus
and stomach, becomes weak or relaxes when it shouldn’t. When reflux happens frequently or
causes inflammation, it may be diagnosed as gastro-oesophageal reflux disease (GORD).

Occasional reflux is common. GORD is more likely when symptoms happen often, continue
over time or start to affect your quality of life.

Symptoms of acid reflux

The most common symptom of acid reflux is heartburn. This is often described as a burning
feeling behind the breastbone, especially after eating or when lying down.

Other symptoms may include:
● Acid or bitter fluid coming back into the mouth
● Chest discomfort
● A persistent cough
● Hoarse voice
● Throat irritation
● Difficulty swallowing
● A feeling of food sticking in the chest
● Burping or bloating
● Symptoms that disturb sleep

Some people have reflux without typical heartburn. This can make the condition harder to
recognise, particularly if symptoms mainly affect the throat, voice or chest.
Persistent chest pain should always be assessed urgently, especially if it’s severe, new or
associated with shortness of breath, sweating or pain spreading to the arm, jaw or back.

You should seek prompt medical advice if you have:

● Difficulty swallowing
● A feeling of food sticking in your chest or throat
● Vomiting blood
● Black stools
● Unexplained weight loss
● Signs of anaemia, such as unusual tiredness, weakness or shortness of breath

What causes acid reflux?

Acid reflux usually develops when the barrier between the stomach and oesophagus doesn’t
work as well as it should. This allows acid to move upwards and irritate the oesophagus.

Factors that can increase the likelihood of reflux include:

● Excess body weight
● Pregnancy
● Smoking
● Alcohol
● Large meals
● Eating late at night
● Fatty foods
● Caffeine
● Chocolate
● Spicy foods
● Some medicines
● Hiatus hernia

A hiatus hernia happens when part of the stomach moves up through the diaphragm. This can
make reflux more likely in some people.

Diagnosing acid reflux

GORD is often diagnosed by discussing your symptoms, how often they happen and how they
respond to initial treatment. Many people don’t need tests straight away.

Further investigation may be recommended if symptoms are severe, persistent or don’t improve
with lifestyle changes and medication. You may also need further assessment if reflux has been
present for many years or if symptoms start for the first time after age 50.

Your doctor may recommend a gastroscopy if they need to look more closely at your
oesophagus and stomach. During this test, a thin flexible camera is passed through the mouth
while you’re sedated or made comfortable. It can help check for irritation, narrowing or changes
caused by long-term reflux.

Some people may need further tests to understand how much acid is coming back up or how
well the oesophagus is moving food towards the stomach. These tests are usually only
suggested if symptoms are ongoing, the diagnosis is unclear or treatment hasn’t worked as
expected.

Acid reflux treatment

Treatment aims to reduce reflux, relieve symptoms and lower the risk of complications.

Lifestyle changes are often the first step. These may include losing weight if needed, avoiding
late meals, reducing alcohol, stopping smoking and raising the head of the bed if night-time
symptoms are a problem.

Medicines may also be recommended. Antacids can help with short-term symptom relief. Acid-
suppressing medicines, such as proton pump inhibitors or H2 blockers, may be used to reduce
acid and help inflammation heal.

Long-term medication should be reviewed with your doctor, especially if symptoms are well
controlled or if you’ve been taking treatment for an extended period.

For some people, reflux symptoms continue despite lifestyle changes and medication. If
symptoms are severe, keep returning or complications develop, your specialist may discuss
surgical or endoscopic treatment.

These treatments aim to reduce reflux by improving the barrier between the stomach and
oesophagus. Your specialist will explain the benefits, risks and suitability based on your
symptoms, test results and general health.

Access expert care with Complete Health Australia

If reflux symptoms are affecting your sleep, eating or day-to-day comfort, we can help you
understand what’s causing them and what to do next.

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