Acid reflux and GERD: symptoms, what helps, and when to see a doctor

A ring of muscle at the bottom of your esophagus (food pipe) normally keeps food and stomach acid in the stomach. Acid reflux happens when this ring is weak or relaxes at the wrong time, so acid flows back up.

Almost everyone gets reflux now and then, for example after a big, oily meal. When it keeps coming back and causes trouble, doctors call it GERD (gastroesophageal reflux disease).

Many Filipinos call it hyperacidity or say they are "sinisikmura". That burning can also come from indigestion, gastritis (an irritated stomach lining) or a stomach ulcer. If your main problem is belly pain, see our stomach pain guide.

A 2011 review of studies across Asia found that GERD had become more common in many Asian countries, possibly linked to changes in diet and way of life.

The two main signs are:

• heartburn: a burning feeling behind the breastbone that can rise toward the throat
• regurgitation: food or a sour, bitter liquid coming up into your throat or mouth

You may also have a cough or hiccups that keep coming back, a hoarse voice or sore throat, bad breath, bloating, burping or nausea. Symptoms are often worse after eating, when lying down and when bending over.

Some people with GERD have no heartburn, only a long-lasting cough. In the Philippines, the DOH TB programme counts a cough of 2 weeks or more as a reason to be checked for TB: see our cough guide.

Trouble swallowing, weight loss and repeated vomiting are not typical reflux. They need a doctor soon. See why GERD should be checked.

A heart attack can feel like bad heartburn, with burning in the chest and a full, bloated feeling. It is easy, and dangerous, to blame it on "hyperacidity" or "hangin".

Call 911 or go to the nearest emergency room now if a burning or heavy chest comes with:

• pain that feels tight, heavy or squeezing
• pain spreading to your arm, neck, jaw or back
• shortness of breath, sweating, nausea, pale or grey skin, or feeling faint

Do not drive yourself, and do not wait to see if an antacid works. A heart attack is more likely if you smoke, are overweight, have high blood pressure, diabetes or high cholesterol, or a close relative had one. Older adults, women and people with diabetes may have little or no chest pain, only shortness of breath, tiredness or weakness. At the emergency room, checks usually start with an ECG (heart tracing).

Often there is no single cause. Reflux is more likely with:

• being overweight, smoking, alcohol and pregnancy
• big meals, or lying down within 3 hours of eating, such as a late dinner after a long commute or a nap right after lunch
• a hiatal hernia, when part of the stomach pushes up into the chest
• H. pylori, a stomach infection that can also cause ulcers
• stress, which can make symptoms feel worse

Common food triggers (they differ from person to person): coffee, including 3-in-1; fatty and fried food such as lechon and chicharon; spicy food; citrus, including kalamansi; tomatoes; chocolate; mint; and alcohol.

Medicines that can worsen reflux include painkillers such as ibuprofen, aspirin and mefenamic acid, some blood pressure and asthma medicines, and sedatives. Never stop a prescribed medicine on your own: ask your doctor. If a doctor told you to take aspirin for your heart, keep taking it and tell the doctor about your heartburn.

For many people these changes are the best acid reflux remedy:

1. Eat smaller meals instead of one or two big ones.
2. Finish eating 3 to 4 hours before bed.
3. Raise the head of your bed by about 10 to 20 cm, with blocks under the bed legs or a foam wedge. Piling up extra pillows can press on your belly and make it worse.
4. Lose weight if you are overweight.
5. Stop smoking and drink less alcohol.
6. Avoid tight belts and waistbands.
7. Keep a food diary for a week or two, and cut down only on what bothers you.
8. For pain, ask your pharmacist about paracetamol instead of ibuprofen, and take all tablets with plenty of water.

Pharmacy medicines. Ask the pharmacist at your botika which suits you, and follow the label.

• Antacids, made with aluminum and magnesium or with calcium, neutralize acid fast, but relief is short.
• Alginates help stop stomach acid from coming back up.

They ease symptoms but do not cure reflux and are not for daily use over a long time. Magnesium can cause diarrhea, and calcium or aluminum constipation. Antacids can stop other medicines working, so ask how far apart to take them. Ask a doctor first if you have kidney or heart disease or high blood pressure, are on a low-salt diet, take medicines every day, are pregnant or breastfeeding, or the medicine is for a child.

Doctor's medicines. If heartburn keeps coming back, a doctor may prescribe a medicine that lowers stomach acid:

• proton pump inhibitors (PPIs) such as omeprazole, which work best and help the food pipe heal
• H2 blockers such as famotidine, if a PPI does not help

A doctor usually prescribes these for a few weeks, then reviews you, and may later advise the lowest amount that works or use only when needed. Side effects are uncommon, such as headache or diarrhea. Do not keep buying omeprazole for weeks on your own. See a doctor so the cause is checked.

A few people whose symptoms do not improve with medicine may be offered surgery. Unsure if a medicine mixes safely with yours? Ask our medicines assistant.

Baking soda in water. It neutralizes acid, but doctors have reported people becoming very ill from taking too much, with dangerous changes in blood salts, kidney injury and, rarely, a torn stomach. It is also high in sodium, the main part of salt. A pharmacy antacid used as the label says is safer. Never give it to children.

"Hyperacidity lang 'yan." Chest burning can be the heart. See Is it acid reflux or your heart?

"Bawal ang lahat ng maasim at maanghang." Sour and spicy foods are common triggers, but not for everyone. A food diary shows what affects you.

"Kabag lang." Gas and reflux can happen together. Reflux is acid coming up into the chest and throat. See our kabag guide.

Many people need no tests. If symptoms are severe, keep returning or come with warning signs, the doctor may suggest an upper endoscopy (a thin camera tube passed down the throat) or a breath or stool test for H. pylori. Tell the doctor if you have been taking omeprazole or a similar medicine: it can hide H. pylori, so you may be asked to stop it for 2 weeks before the test.

Acid that keeps coming up can cause:

• inflammation or ulcers in the food pipe, which can bleed
• narrowing of the food pipe from scarring, making swallowing hard
• Barrett's esophagus, a change in the lining that can raise the risk of cancer of the food pipe (studies in Asia have found it uncommon)
• a long-lasting cough or hoarse voice, worse asthma, and damage to the teeth

Pregnancy. Heartburn is common in pregnancy. Ask your doctor or midwife at your prenatal check-up before taking any medicine, and tell the pharmacist you are pregnant. If you take iron or folic acid, ask how far apart to take them from an antacid, because antacids can stop them being absorbed.

Heartburn that does not go away with heartburn medicine, or pain below the ribs, can be a sign of pre-eclampsia (high blood pressure in pregnancy), especially with a severe headache, blurred vision or sudden swelling of the face, hands or feet. Go to the hospital now. This can also happen in the weeks after giving birth.

Babies and children. Reflux in children is different. Do not give antacids, baking soda or acid medicines unless a doctor advises it.

Older adults. If you are 55 or older, see a doctor if heartburn does not get better with treatment, and soon if you are also losing weight. The doctor may suggest an endoscopy.

For heartburn that keeps coming back, go to your barangay health station, rural health unit (RHU) or city health center: find one near you. A doctor may refer you to a gastroenterologist (stomach specialist). Ask the price of an endoscopy first at a private hospital.

PhilHealth YAKAP. Every Filipino with a PhilHealth number (PIN) can register with a YAKAP clinic. PhilHealth's July 2025 FAQ says check-ups and the listed lab tests there are free, a private YAKAP clinic may charge up to ₱900 a year, and medicines your YAKAP doctor prescribes are free through GAMOT, up to ₱20,000 per person a year.

As of 2026, the GAMOT list includes an antacid (aluminum hydroxide with magnesium hydroxide) and omeprazole for GERD when your YAKAP doctor prescribes them. Each time, the pharmacy gives up to 7 days of the antacid or 14 days of omeprazole. See our PhilHealth YAKAP guide.

Emergency room. PhilHealth's Outpatient Emergency Care Benefit covers chest pain, difficulty swallowing, persistent vomiting and bleeding. If an accredited hospital's emergency room sends you home within 24 hours, PhilHealth pays fixed fees for the listed tests, such as an ECG, and medicines (as of 2025). If you are admitted, other PhilHealth benefits apply. See what PhilHealth covers.

Not sure it is reflux? Ask our symptoms assistant or book a call with a nurse.