If you’ve ever had acid reflux, you know it’s a feeling you can never really forget: the searing burning in your chest makes it hard to relax, sleep, or enjoy eating.

Acid reflux occurs when your stomach contents move back into your esophagus, causing pain and discomfort. For some people, acid reflux hits once in a blue moon—but for others, it’s a frequent occurrence. If you experience acid reflux more than twice a week, you could have gastroesophageal reflux disease, or GERD.

Unfortunately, GERD is incredibly common. It affects as many as 20% of Americans, and 60% of GERD sufferers are women (1).

Cases of acid reflux and GERD are rising fast. In 1989, 5% of people in western countries suffered from acid reflux. Since 1995, that percentage has risen by a whopping 50%! (2) Many experts believe stress can make GERD worse, so it’s no surprise that our fast-paced world is causing GERD case numbers to climb (3).

If you think you might have GERD, here’s everything you need to know about managing the condition.

Wondering how to diagnose GERD? Here are some common symptoms that you might experience…

For starters, the most telling symptom of GERD is acid reflux, often referred to as heartburn. This makes for a burning sensation in your chest that sometimes moves up to your neck or throat. You may also experience a bitter taste at the back of your throat, and your stomach might regurgitate some of the food or drinks from your stomach into your mouth.

Not all instances of heartburn are a sign of GERD. Many people experience occasional heartburn, and if it isn’t a common occurrence, it’s probably not a sign that you have GERD. However, if you’ve been experiencing it more than twice a week—especially if it’s been coupled with the symptoms below—you could have GERD.

In addition to heartburn, GERD symptoms include:

• Chest Pain
• Nausea
• Chronic Cough
• Painful Swallowing
• Difficulty Swallowing
• Bad Breath
• Hoarse Voice

Why does GERD happen? There’s no single cause of GERD, but there are certain factors that can contribute to it or increase your likelihood of developing it.

One common assumption is that GERD is caused by having too much stomach acid, but that’s not quite the case. When people believe they have too much stomach acid, what’s actually happening is that the lower esophageal sphincter (or LES) isn’t working properly (4, 5). The LES is a band of muscle located at the end of the esophagus.

A properly functioning LES opens and relaxes when you swallow, then tightens and closes again afterward. But if the LES doesn’t close or tighten when it’s supposed to, stomach contents—no matter how much or little you have—will pass through the open LES into the esophagus and you’ll experience acid reflux (6, 7).

Some other reasons the LES might not work properly include:

• Regularly eating large meals. This can cause the upper part of the stomach to distend, which removes pressure off the LES and can stop it from working as efficiently.
• Laying down soon after a large meal. This can have the same effect on the LES as the meal does.
• Hiatal hernia. This happens when the stomach moves above the diaphragm, toward your chest. This can make it harder for the LES to function correctly.

Certain lifestyle and health factors can make it more likely for you to experience GERD, including:

• Pregnancy
• Connective Tissue Disorders
• Carrying Extra Weight
• Smoking
• Eating Tomatoes, Tomato Sauce, Onions, Mint, or Fried Foods
• Drinking Coffee, Soda, or Alcohol
• Regularly Laying Down or Sleeping Right After Eating
• Regularly Taking NSAIDs

There are a few other health conditions that may exacerbate your GERD symptoms…

Research has found a connection between anxiety and heartburn (8). If your anxiety is ramping up, your GERD symptoms might increase as well—though some experts believe GERD may cause anxiety because its symptoms can be stressful.

If you’re pregnant, you are at a higher risk of heartburn-related health issues, because hormonal changes in pregnancy can cause your LES to relax more often than it normally would (9). If you already had GERD before getting pregnant, you might see an increase in your symptoms. Asthma and GERD regularly occur together, as do GERD and irritable bowel syndrome (10, 11).

Many people take over-the-counter medications for GERD like antacids, H2 receptor blockers (like Pepcid AC), or Proton Pump Inhibitors (PPIs). These can help with symptoms in the short-term, but are primarily focused on reducing your stomach acid, which as you now know, is not a true solution to GERD.

If you have GERD, it’s best to focus on a long-term solution that gets to the root of the problem in order to heal the direct cause of your symptoms. If you’re on medication and want to try a different approach, here are some options…

• Maintain a healthy weight if you’re able to
• Avoid eating large, heavy meals in the evening
• Wait a few hours after eating before lying down
• When sleeping, keep your head elevated 6 to 8 inches. One way to do this is by putting risers underneath the two legs at the top of your bed. Or lying on a wedge pillow. Both of these items can be purchased on Amazon. Search for “bed risers” or “wedge pillow”.
• Avoid drinking water or other liquids during meals
• Avoid smoking
• Avoid carb-heavy foods
• Try an HCL supplement, like Betaine HCL with Pepsin. HCL is used to increase your stomach acid, as low stomach acid can actually cause heartburn and even slow your body’s absorption of nutrients (12, 13). While Pepsin helps your stomach digest food more easily by breaking down proteins (14, 15).
• Take bitter herb supplements like Iberogast. This herbal blend, which includes ingredients like peppermint and licorice root, can help reduce symptoms of indigestion, stomach pain, and heartburn (16). Some research even suggests that Iberogast may work as well as an over-the-counter antacid, without the stomach acid “rebound” that can occur with typical medications (17).
• Take probiotics daily. These healthy bacteria help keep your gut in balance, and they may be able to decrease acid reflux symptoms while reducing your risk of relapse (18, 19, 20). One study even indicated that probiotics may reduce the risk of changes to your gut flora caused by long-term use of over-the-counter PPIs (21).

GERD is a concerningly common condition. It’s usually caused by the lower esophageal sphincter (LES) not functioning properly, which allows stomach acid to move up into the throat, causing heartburn. While over-the-counter medication for GERD can help, they don’t address the root cause of the condition. This is where more sustainable, natural solutions come into play: lifestyle changes (like avoiding liquids during meals or lying down too soon after a meal), HCL supplements, bitter herbs, and probiotic supplements like NativePath Probiotics. This prebiotic and probiotic blend features 10 unique superstrains and 2.75 billion CFUs per capsule to help alleviate symptoms of GERD.