Adjust your meals
Eat slowly and avoid very large meals.3,5 Don’t eat in the 2 to 3 hours before bedtime, and avoid lying down for 2 hours after a meal.1
Health education · DigestionDigestive health
Gastroesophageal reflux: causes, symptoms and treatments
Burning after meals, a sour taste in the mouth or reflux when lying down can point to gastroesophageal reflux disease (GERD).
Reflux is when some of the stomach’s contents flow back up into the esophagus, the tube that carries food from the mouth to the stomach.3 When it becomes frequent, bothersome or causes damage, it needs appropriate care.
Causes
Why does reflux happen?
Where the esophagus meets the stomach, a muscle called the lower esophageal sphincter acts as a valve. It opens to let food through, then closes. If it doesn’t close properly, acidic stomach contents can flow back up and irritate the esophagus.5
Reflux therefore mainly comes from a problem with this valve.5 Triggers vary from person to person.
Symptoms
What are the symptoms?
Typical symptoms are heartburn and acid regurgitation.5 In some people, other symptoms are the only signs of reflux.5
A chronic cough, hoarseness (especially in the morning), a persistent sore throat or a lump-in-the-throat feeling can also be linked to reflux.3,5 However, these symptoms can have other causes: they are not enough to confirm the diagnosis.
Watch out for chest pain
A heart attack can feel like burning in the chest or indigestion.6
Call 911 for pain, pressure or discomfort in the chest, especially if the pain spreads to the arms, neck, jaw or shoulders, or comes with shortness of breath, sweating, paleness, weakness or nausea.6 Don’t assume it is reflux.
Seeking care
When should you see a professional?
If you are unsure where to go, call Info-Santé at 811, option 1.
An assessment is recommended in particular if:
- heartburn occurs at least twice a week;4
- you need over-the-counter antacids more than twice a week;4
- symptoms occur more than 3 days a week;3
- they persist despite changes in habits;3
- over-the-counter medications taken regularly for 4 weeks do not help;3
- a medication that used to work no longer helps;3
- digestive symptoms start suddenly after age 50.4
When should you get a prompt assessment?
Seek care promptly if you have:1,2,4
- difficulty swallowing or a feeling that food gets stuck;
- pain when swallowing;
- unintentional weight loss;
- persistent vomiting;
- anemia.
Vomiting blood or material that looks like coffee grounds, or black, tarry or bloody stools, are signs of digestive bleeding and need urgent assessment.4
Assessment
How is reflux assessed?
The assessment starts with the symptoms, how often they occur, how long they last and how they affect daily life. The professional also reviews medications and looks for warning signs.
In people under 60 with upper digestive symptoms and no warning signs, a gastroscopy is not recommended right away: treatment is tried first.2 It may be offered when there are warning signs, such as worsening difficulty swallowing, anemia or weight loss.2
Possible tests
A gastroscopy lets the professional examine the esophagus and stomach and take samples if needed.
Esophageal pH monitoring measures how much acid reaches the esophagus. It is used in particular to confirm the diagnosis before anti-reflux surgery is considered.5
Habits
Which habits can help?
These measures are recommended to reduce reflux symptoms:1
Identify your triggers
Fried, spicy or acidic foods, chocolate, peppermint and caffeine can trigger symptoms.1 Mainly limit the ones that make your reflux worse.
Reduce night-time symptoms
Raise the head of the bed by about 15 cm and preferably sleep on your left side.1,3
Tobacco and alcohol
Limit alcohol, and limit or stop smoking.1
Weight
If you are overweight, losing weight can help reduce symptoms.1
You don’t need to cut out every trigger food: mainly limit the ones you notice make your symptoms worse.
Medications
Which medications can be used?
The choice depends on how often and how severe the symptoms are, your medical history and your other medications.
| Type of medication | Role |
|---|---|
| Antacids | Neutralize acid; useful for occasional heartburn.1 |
| H2-receptor antagonists (H2 blockers) | Reduce the amount of acid the stomach makes.1 |
| Proton pump inhibitors (PPIs) | Reduce acid production. They relieve reflux but do not cure it: symptoms often return when they are stopped.5 |
A pharmacist can help you choose a product and check precautions and interactions. Regular use of over-the-counter medications should be reassessed if symptoms persist.3
Do you have to take a PPI for life?
Not necessarily. PPIs should be taken at the lowest effective dose, for the time needed, and the reason for taking them should be checked.2 Trying to reduce or stop them at least once a year is recommended for most people.2
The dose can be reduced, for example, by switching to once a day, every other day or as needed.1 Symptoms may come back briefly and usually go away within a few days; an antacid or H2 blocker can help during this time.1
Some conditions, such as Barrett’s esophagus, severe esophagitis or digestive bleeding, require long-term treatment.1,2 Discuss any change with your professional.
Complications
What are the possible complications?
Persistent reflux can sometimes lead to:5
- esophagitis, damage to the lining of the esophagus, which can lead to a bleeding ulcer;
- narrowing of the esophagus due to scarring, which makes it harder for food to pass;
- Barrett’s esophagus, a change in the lining that increases the risk of esophageal cancer.
These complications do not happen to everyone with reflux. Testing and follow-up depend on each person’s situation.
The diary
How can you prepare for your visit?
Keeping a diary for one to two weeks helps understand how symptoms change and tailor the advice.4 Also bring a list of your medications, including over-the-counter ones.4
You can record:4
- the time and content of meals;
- when symptoms start and how severe they are;
- their link with lying down and waking at night;
- foods that seem to trigger them;
- medications taken and how much they helped.
Don’t wait to finish the diary if a warning sign appears.
When to consult at the Clinique IPS du Palais?
A nurse practitioner can assess your symptoms, review your habits and medications, offer suitable treatment, review a PPI you have taken for a long time and order tests or a specialist consultation when indicated.
If you have chest pain or discomfort that could be a heart problem, call 911.
Sources
- Institut national d’excellence en santé et en services sociaux (INESSS). Déprescription des inhibiteurs de la pompe à protons (IPP) : algorithme décisionnel, part 2 (in French). July 2025, accessed October 29, 2026. inesss.qc.ca
- Choosing Wisely Canada, Canadian Association of Gastroenterology. Gastroenterology (recommendations). Updated July 2025, accessed October 29, 2026. choisiravecsoin.org
- Brochu M, Programme santé physique médecine. Le reflux gastro-œsophagien (hyperacidité gastrique – brûlures d’estomac) (in French). Version of July 23, 2024, hosted by Santé Montérégie, accessed October 29, 2026. santemonteregie.qc.ca
- Glinski S, Canadian Digestive Health Foundation. GERD symptom checklist: how to track your acid reflux and when to see your doctor. August 13, 2026, updated August 18, 2026, accessed October 29, 2026. cdhf.ca
- Canadian Digestive Health Foundation. Gastroesophageal reflux disease (GERD). Page modified May 11, 2026, accessed October 29, 2026. cdhf.ca
- Public Health Agency of Canada. Signs and symptoms of a heart attack. Modified February 12, 2026, accessed October 29, 2026. canada.ca
This sheet mainly concerns reflux in adults. It provides general information and does not replace an assessment by a health professional. Published October 29, 2026.