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Causes of Acid Reflux

Food

Eating large meals increases the pressure in the stomach and the likelihood of transient lower oesophageal sphincter relaxations (TLOSRs).

The following foods make reflux worse by relaxing the lower oesophageal sphincter:

  • Coffee (even decaffeinated)
  • Chocolate
  • Fizzy drinks
  •  
  • Alcohol

These foods are acidic and cause direct irritation of the oesophagus:

  • Citrus fruit such as oranges, lemons and grapefruit
  • Orange juice
  • Spicy foods such as curry
  •  
  • Tomatoes

Medicines

People do not realise that some of the medicines they take can be potent acid reflux causes. A slight change to medicines taken for other reasons, can make a big difference to the symptoms they suffer.

Once again, medicines can be divided into those which directly irritate the oesophagus and those which relax the lower oesophageal sphincter and make acid reflux more likely to occur.

Direct Irritation:

  • Anti-inflammatory painkillers (such as ibuprofen or aspirin)
  • Bisphosphonates (such as alendronate)

Medicines which cause reflux by relaxing the lower oesophageal sphincter

Muscle relaxants such as diazepam, theophylline, nitrates, and calcium channel blockers egnifedipine or amlodipine.

Other drugs can also cause reflux. Please discuss with your doctor if you think a drug is causing or aggravating the symptoms.

Other

Weight:

Acid reflux causes include overweight. This group of peope are at particular risk. It is particularly marked in people with central obesity (beer belly!). The reason is simple. The fat in the abdomen places pressure on the stomach and this forces the acid contents back up into the oesophagus, particularly after a large meal.

Posture:

If you lie down or bend forward a lot during the day, this will encourage reflux. If you sit hunched (perhaps in front of your computer for long periods?!) or if you wear a tight belt, this may put extra pressure on the stomach which may make reflux worse.

Bedtime:

We have already said that most reflux occurs within two hours of meals. Most reflux episodes resolve because gravity pulls the acid back into the stomach. But, if a person lies down too soon after eating, gravity cannot act. So, going to bed within two hours after eating is an important cause of heartburn or reflux in the night.