Could you have acid reflux and not know it?

Everyone experiences the occasional heartburn or indigestion after a heavy meal. But what if those symptoms are signs of something more persistent and you don’t even realize it?

Acid reflux can be misdiagnosed and is an underdiagnosed problem. Many people have acid reflux problems, but they don’t seek care from a physician. Instead, they treat themselves with over-the-counter medication.

Let’s explore everything you need to know about acid reflux and whether you can have acid reflux and not know it.

What is acid reflux?

Acid reflux happens when the acid in your stomach flows back into your esophagus, the tube that connects your mouth to your stomach. This backflow can irritate the lining of your esophagus and cause uncomfortable symptoms. 

What does acid reflux feel like?

The most classic symptom of acid reflux is heartburn, a burning sensation in your chest. However, a sizeable number of patients with acid reflux do not experience heartburn at all. In fact, it can show up in ways that are easy to misinterpret or miss. So, what does acid reflux feel like?

For some, it’s a sharp or dull chest pain that feels like it could be heart-related. Some may experience episodes of squeezing or spasms in the chest.

For others, it’s a persistent cough, hoarseness or a sour taste in the back of the throat. You might feel bloated, nauseated or just “off” after eating—even if the meal wasn’t particularly spicy or heavy. These symptoms can be subtle, and they don’t always seem related to digestion.

Here are some of the ways acid reflux might show up:

• A sour, bitter taste in your mouth
• Chest pain or discomfort
• Chronic cough or hoarseness
• Nausea
• Regurgitation, feeling like food or liquid is coming back up
• Throat irritation
• Wheezing

Because these symptoms vary so much, it’s easy to miss the connection. That’s why many people ask, “Can you have acid reflux and not know  it?” And the answer is yes.

What causes acid reflux?

Several lifestyle factors can contribute to acid reflux, including:

• Being overweight
• Consuming spicy or acidic foods
• Drinking too much caffeine or alcohol
• Eating large meals, especially before bedtime
• Pregnancy
• Smoking

Common foods that cause acid reflux

While food and drink most likely aren’t enough to cause acid reflux alone, they can contribute to it. Some of the most common foods that can cause acid reflux include:

• Alcohol
• Caffeinated beverages, such as coffee, tea or energy drinks
• Cheese
• Chocolate
• Citrus fruits, such as oranges, lemons and grapefruits
• Fatty meats, such as bacon or sausage
• Fried foods
• Spicy foods
• Tomatoes and tomato products
• Vinegar

It also may not be the food you eat, but the quantity of what you eat. So, instead of having three cups of coffee, have one, and see if that improves your symptoms.

How to know if you have acid reflux

Think you’re living with acid reflux? Here are three simple ways to find out.

1. Pay attention to subtle symptoms

Chest discomfort, chronic cough or hoarseness may be signs of acid reflux. Keep a symptom journal to track when and how often these occur.

2. Examine your diet

Are you eating a lot of spicy or acidic food? Do you drink too much caffeine or acidic beverages? See how you feel if you cut back or eliminate certain foods or drinks and pay attention to if your symptoms improve.

3. Try non-prescription or over-the-counter remedies for acid reflux

If diet and lifestyle changes don’t help, try using over-the-counter (OTC) medications or non-prescription medications to alleviate your symptoms. There are three kinds of OTC medications to treat heartburn and acid reflux:

• Antacids: Antacids treat indigestion by neutralizing stomach acid that causes heartburn.
• Histamine-2 (H2) blockers: H2 blockers reduce the amount of acid your stomach produces
• Proton pump inhibitors (PPIs): OTC proton pump inhibitors reduce the amount of acid produced by the stomach over time.

PPIs need to be taken regularly for at least a few days to become effective and are intended to suppress episodes frequent heartburn (two or more days a week). They are not intended for immediate relief.

Always follow dosage instructions and consult your doctor or pharmacist if you’re taking other medications.

If you’d prefer an alternative to medication, try natural remedies to help prevent or treat acid reflux. You may also find that lifestyle changes, such as managing stress levels, keeping your head elevated while sleeping and not eating for at least 4 hours before going to bed can be helpful at reducing the severity and frequency of symptoms. If you are overweight, weight loss can oftentimes help reduce the severity of acid reflux as well.

When to see a doctor for acid reflux

If symptoms persist or worsen, it’s time to talk to your doctor.

Although acid reflux is common and usually manageable, don’t ignore it. If your symptoms persist or worsen, it’s time to talk to your doctor —especially if they’re affecting your daily life or not improving lifestyle changes.

Talk to your primary care provider or a digestive specialist if:

• Non-prescription or over-the-counter medications aren’t helping
• You have a family history of cancer in the esophagus or stomach
• You’re experiencing symptoms more than twice a week
• You have trouble swallowing or persistent chest discomfort
• You’re unsure whether your symptoms are related to acid reflux, or something else

Your care team can help you find relief and prevent long-term issues. Whether it’s through dietary changes, medication or further testing, you have options and support. Connect with a digestive specialist to get relief for acid reflux