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Acid reflux
Gastric discomfort
Heartburn
Pain in the middle of the upper stomach
Gas
There is a feeling that the stomach is burning
Feeling stressed
Not seeing your symptoms? No worries!
A condition where stomach acid flows back up the esophagus (food pipe). It can be caused or worsened by obesity, alcohol, and caffeine. Eating habits also play a role - eating large meals quickly or lying down after meals are known triggers.
Your doctor may ask these questions to check for this disease:
Treatment starts with lifestyle changes like eating smaller meals and taking a walk after heavy meals. Medications to reduce stomach acid or speed up digestion may be helpful. In severe cases, patients can undergo procedures or surgery.
Reviewed By:
Scott Nass, MD, MPA, FAAFP, AAHIVS (Primary Care)
Dr. Nass received dual medical degrees from the David Geffen School of Medicine at UCLA and Charles R. Drew University in Medicine and Science. He completed Family Medicine residency at Ventura County Medical Center with subsequent fellowships at Ventura, University of North Carolina-Chapel Hill, George Washington University, and University of California-Irvine. He holds faculty appointments at Keck School of Medicine of USC, Loma Linda University School of Medicine, and Western University of Health Sciences.
Aiko Yoshioka, MD (Gastroenterology)
Dr. Yoshioka graduated from the Niigata University School of Medicine. He worked as a gastroenterologist at Saiseikai Niigata Hospital and Niigata University Medical & Dental Hospital before serving as the Deputy Chief of Gastroenterology at Tsubame Rosai Hospital and Nagaoka Red Cross Hospital. Dr. Yoshioka joined Saitama Saiseikai Kawaguchi General Hospital as Chief of Gastroenterology in April 2018.
Content updated on Feb 13, 2025
Following the Medical Content Editorial Policy
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Q.
Acid Reflux in Women 30-45: Root Causes & Essential Next Steps
A.
There are several root causes to consider, including hormonal shifts, pregnancy, weight changes, stress, individual diet triggers, and certain medications; frequent or nighttime symptoms may indicate GERD. Essential next steps are to track patterns, adjust meal size and timing, elevate the head of the bed and sleep on the left, manage weight and stress, use short-term OTC meds, and seek prompt care for red flags like chest pain or trouble swallowing; see below for key details that could change which steps are right for you.
References:
* Vahdat S, Kianian F, Fakhrie H, et al. Hormonal Contraceptives May Exacerbate Symptoms of Gastroesophageal Reflux Disease in Women. *Dig Dis Sci*. 2022 Mar;67(3):805-809. doi: 10.1007/s10620-022-07384-w. PMID: 35149957.
* Kim K, Kim BJ, Kim YS, et al. Gender differences in the clinical characteristics and treatment outcomes of gastroesophageal reflux disease: a systematic review. *J Dig Dis*. 2018 Sep;19(9):514-521. doi: 10.1111/jdd.13322. PMID: 29770544.
* Ribolsi M, Cicala M, Ciarleglio FA, et al. Influence of Gender on Gastroesophageal Reflux Disease. *Front Med (Lausanne)*. 2022 Feb 16;9:826955. doi: 10.3389/fmed.2022.826955. PMID: 35252277.
* Modi R, Crater Z. Women and gastroesophageal reflux disease: clinical characteristics and treatment strategies. *Ther Adv Gastroenterol*. 2014 Jun;7(3):148-58. doi: 10.1177/1756283X14529329. PMID: 24795797.
* Law R, Marwaha A, Gill T, et al. Gastroesophageal reflux disease in pregnancy: A systematic review and meta-analysis. *Eur J Obstet Gynecol Reprod Biol*. 2020 Jan;244:172-179. doi: 10.1016/j.ejogrb.2019.11.025. PMID: 31733671.
Q.
Famotidine for Women 30-45: Manage Reflux & Your Next Steps
A.
Famotidine is an H2 blocker that lowers stomach acid and can safely ease reflux symptoms for many women 30 to 45, especially when paired with lifestyle steps; use as directed for short-term relief and reassess if you need it daily beyond two weeks. There are several factors to consider, including pregnancy or breastfeeding, kidney disease, other medications, dosing and timing, alternatives like antacids or PPIs, and red flags such as trouble swallowing, chest pain, vomiting blood, black stools, or weight loss that require prompt care. See below for full guidance and your step-by-step next steps.
References:
* Gill, S. K., O'Brien, L., Koren, G., & van Uum, S. (2020). Safety of H2-receptor antagonists and proton pump inhibitors during pregnancy: a comparative meta-analysis. *Gastroenterology Report*, *8*(3), 167-174. doi:10.1093/gastro/goaa018
* Källén, B. (2019). Use of Histamine H2 Receptor Antagonists During Pregnancy and Risk of Congenital Malformations. *Drug Safety*, *42*(7), 891-896. doi:10.1007/s40264-019-00824-3
* Li, M., Li, Y., Wu, M., Huang, Y., Zhang, X., & Li, M. (2023). Efficacy and Safety of Famotidine in Patients with Gastroesophageal Reflux Disease: A Systematic Review and Meta-Analysis. *Digestive Diseases and Sciences*, *68*(1), 18-29. doi:10.1007/s10620-022-07663-1
* Khan, M., Kamran, U., & Khan, Z. (2022). The role of H2 receptor antagonists in the treatment of gastroesophageal reflux disease: a systematic review and meta-analysis. *Gastroenterology Research*, *15*(2), 65-71. doi:10.14740/gr1533
* Kahrilas, P. J., & Spechler, S. J. (2023). Gastroesophageal Reflux Disease. *The New England Journal of Medicine*, *388*(4), 319-330. doi:10.1056/NEJMcp2207005
Q.
Gabapentin for Women 30-45: Side Effects, Safety & Your Action Plan
A.
Gabapentin can help women 30 to 45 with nerve pain, migraines, fibromyalgia, sleep issues and hot flashes, but common side effects include drowsiness, dizziness, fatigue, brain fog, swelling, weight gain and nausea, with rarer risks like mood changes or suicidal thoughts, allergic reactions and breathing problems, especially when used with opioids or other sedatives. For safety, start low and go slow, limit alcohol, avoid driving until you know your response, review all medications for interactions, never stop suddenly, and talk to your doctor if pregnant, planning pregnancy or breastfeeding. There are several factors to consider; see the complete action plan, red flags, and next steps for your situation below.
References:
* Schakallis K, et al. Gabapentinoids: Clinical Pharmacology and Potential for Abuse. CNS Drugs. 2018 Oct;32(10):917-927. doi: 10.1007/s40263-018-0570-8. PMID: 30187295.
* Wiffen PJ, et al. Gabapentin for neuropathic pain in adults. Cochrane Database Syst Rev. 2017 Jun 12;6(6):CD007938. doi: 10.1002/14651858.CD007938.pub4. PMID: 28608556.
* Bobo WV, et al. Pregnancy and Lactation While Using Gabapentinoids. J Clin Psychopharmacol. 2020 Sep/Oct;40(5):497-505. doi: 10.1097/JCP.0000000000001243. PMID: 32773663.
* Smith RV, et al. Gabapentin and pregabalin: A critical review of clinical experience. Expert Rev Clin Pharmacol. 2019 Jul;12(7):645-661. doi: 10.1080/17512433.2019.1623990. PMID: 31190458.
* Kretzschmar S, et al. Gabapentin and pregabalin for pain: an update for safe prescribing and harm reduction. Expert Rev Neurother. 2020 Sep;20(9):893-903. doi: 10.1080/14737175.2020.1762514. PMID: 32375084.
Q.
GERD in Women 30-45: Vital Symptoms & Your Relief Action Plan
A.
Women 30 to 45 commonly experience GERD as heartburn, sour taste, and regurgitation, but it can also show up as chronic cough, frequent throat clearing, hoarseness, chest discomfort, nausea, bloating, and worse at night, with risk increased by hormones, pregnancy, weight changes, stress, and certain medications. Relief steps include smaller meals, avoiding lying down for 2 to 3 hours after eating, identifying trigger foods, elevating the bed and sleeping on the left side, managing stress, and using antacids, H2 blockers, or PPIs with medical guidance, while seeking urgent care for severe chest pain, vomiting blood, black stools, or painful or difficult swallowing. There are several factors to consider, including pregnancy safety, testing, and long term risks, so see the complete guidance below to choose the right next steps.
References:
* Fass R, et al. Sex and gender differences in gastroesophageal reflux disease. Dig Dis Sci. 2017 Jul;62(7):1663-1678. PMID: 28447239.
* Yadlapati R, et al. AGA Clinical Practice Update on the Personalized Management of Gastroesophageal Reflux Disease: Expert Review. Clin Gastroenterol Hepatol. 2022 Mar;20(3):477-486.e1. PMID: 34186411.
* Kahrilas PJ, et al. Extraesophageal manifestations of gastroesophageal reflux disease: Diagnostic challenges and management options. Nat Rev Gastroenterol Hepatol. 2020 Aug;17(8):462-475. PMID: 32472147.
* Katzka DA, et al. Lifestyle and dietary modifications for the management of gastroesophageal reflux disease: a systematic review. J Clin Gastroenterol. 2015 Mar;49(3):192-200. PMID: 25489693.
* GBD 2019 Gastroesophageal Reflux Disease Collaborators. Global, regional, and national burden of gastroesophageal reflux disease in 204 countries and territories, 1990-2019: A systematic analysis for the Global Burden of Disease Study 2019. Lancet Gastroenterol Hepatol. 2022 May;7(5):427-440. PMID: 35395277.
Q.
Hiatal Hernia in Women 30-45: Symptoms & Your Action Plan
A.
In women 30 to 45, hiatal hernia is common and often tied to reflux symptoms like heartburn, sour taste, chest discomfort, bloating, or trouble swallowing that worsen after large meals or when lying down. Start with smaller frequent meals, identify and limit triggers, manage weight, elevate the head of the bed, avoid tight clothing and straining, and use antacids, H2 blockers or PPIs with medical guidance, but seek urgent care for severe chest pain, vomiting blood, black stools, or worsening swallowing. There are several factors to consider, so see the complete action plan, pregnancy considerations, diagnostic tests, and when surgery is needed below to guide your next steps.
References:
* pubmed.ncbi.nlm.nih.gov/27599768/
* pubmed.ncbi.nlm.nih.gov/24962228/
* pubmed.ncbi.nlm.nih.gov/36569614/
* pubmed.ncbi.nlm.nih.gov/25680373/
* pubmed.ncbi.nlm.nih.gov/29515664/
Q.
Omeprazole for Women 30-45: Safety, Risks & Your Action Plan
A.
Omeprazole for women 30 to 45 is generally safe short term and effective for GERD and ulcers, but longer use should be doctor guided due to risks like vitamin B12 and magnesium deficiency, bone effects, gut infections, and rebound acid after stopping; confirm the diagnosis and use the lowest effective dose. There are several factors to consider. See details below for your step-down and taper plan, lifestyle changes that may reduce or replace medication, when to check labs or bone health, pregnancy guidance, and urgent warning signs that mean you should seek care.
References:
* Eom CS, et al. Proton Pump Inhibitors and Risk of Adverse Effects: A Systematic Review. J Korean Med Sci. 2016 Sep;31(9):1339-45. doi: 10.3346/jkms.2016.31.9.1339. Epub 2016 Aug 8. PMID: 27508316; PMCID: PMC4976725.
* Gill SK, et al. Safety of proton pump inhibitors in pregnancy: a systematic review and meta-analysis. Clin Gastroenterol Hepatol. 2019 Aug;17(9):1694-1704.e5. doi: 10.1016/j.cgh.2019.04.040. Epub 2019 Apr 26. PMID: 31097486.
* Zhou B, et al. Association Between Proton Pump Inhibitor Use and Risk of Osteoporosis and Fracture: A Meta-Analysis. Osteoporos Int. 2018 Sep;29(9):2001-2010. doi: 10.1007/s00198-018-4565-4. Epub 2018 May 14. PMID: 29759322.
* Majumdar A, et al. Long-term proton pump inhibitor use and chronic kidney disease: a systematic review and meta-analysis. Nephrol Dial Transplant. 2020 Oct 1;35(10):1741-1750. doi: 10.1093/ndt/gfz196. PMID: 32375836.
* Kinoshita Y, et al. Adverse effects of proton pump inhibitors: clinical and pharmacological overview. J Clin Biochem Nutr. 2021 Jan;68(1):11-21. doi: 10.3164/jcbn.20-137. Epub 2020 Oct 26. PMID: 33481023; PMCID: PMC7806509.
Q.
Tums for Women 65+: Heartburn Relief, Bone Health & Side Effects
A.
Tums for women 65+ can provide fast, occasional heartburn relief and modest calcium for bone health, but there are several factors to consider. See below for safe dosing and how long to use them, timing to avoid interactions with thyroid, antibiotic, iron, and osteoporosis medicines, possible side effects like constipation and rare risks like high calcium or kidney stones, red flags that suggest GERD or the need to see a doctor, and lifestyle or alternative treatments for frequent symptoms.
References:
* Malfertheiner P. Management of gastroesophageal reflux disease in the elderly: a review. Digestion. 2004;70 Suppl 1:30-4. doi: 10.1159/000080644. PMID: 15509204.
* Bischoff-Ferrari HA, Orav EJ, Dawson-Hughes B. Calcium supplementation and fracture prevention in postmenopausal women: a meta-analysis. Osteoporos Int. 2015 Feb;26(2):491-9. doi: 10.1007/s00198-014-2983-9. Epub 2015 Jan 3. PMID: 25556754; PMCID: PMC4297615.
* Wang L, et al. Adverse events associated with calcium intake in clinical trials: a systematic review and meta-analysis. Ann Intern Med. 2012 Jan 17;156(3):195-202. doi: 10.7326/0003-4819-156-3-201202070-00005. PMID: 22190013.
* Dawson-Hughes B, et al. Calcium and vitamin D supplementation: a review of treatment guidelines. J Clin Densitom. 2012 Jul-Sep;15(3):263-8. doi: 10.1016/j.jocd.2012.02.003. Epub 2012 Mar 9. PMID: 22421917.
* Vaezi MF, et al. Pharmacological management of gastroesophageal reflux disease in the elderly: current and future perspectives. Expert Opin Pharmacother. 2015 May;16(7):1063-74. doi: 10.1517/14656566.2015.1018903. Epub 2015 Mar 2. PMID: 25732168.
Q.
Can you die from acid reflux in your sleep?
A.
It is extremely rare to die during sleep from acid reflux, but it can happen indirectly through aspiration with choking or pneumonia, severe respiratory compromise, or cardiac events, especially in people with advanced lung disease, neurologic impairment, poor airway protection, or untreated severe GERD. There are several factors to consider, see below to understand more. Know the red flags like sudden severe chest pain, breathing trouble on waking, blood in vomit, weight loss, or difficulty swallowing and seek urgent care if present, while others should review the prevention and treatment options outlined below and talk with a clinician if symptoms persist.
References:
Spechler SJ, & Souza RF. (2014). Barrett's esophagus. N Engl J Med, 24178690.
Katz PO, & Gerson LB, & Vela MF. (2013). Guidelines for the diagnosis and management of gastroesophageal ref... Am J Gastroenterol, 23377727.
Herregods TV, & Bredenoord AJ, & Fox MR, & Smout AJ. (2012). Weakly acidic reflux in GERD: mechanisms and clinical implication... Gut, 21868473.
Q.
Does milk help acid reflux?
A.
Milk can offer brief soothing by neutralizing stomach acid, but it often triggers rebound acid within an hour and, especially if high fat, can slow stomach emptying and relax the lower esophageal sphincter, worsening reflux. There are several factors to consider, including opting for low fat milk or non dairy alternatives and addressing meal timing and other triggers; see below for important details and red flags that can guide your next steps.
References:
Tytgat GNJ. (1975). Acid secretion in man after meals and the influence of milk. Gut, 1086104.
Nilsson M, Johnsen R, Ye W, Hveem K, & Lagergren J. (2004). Lifestyle characteristics important for the development of gastro-oesophageal reflux… Gut, 14514614.
Tutuian R, Vela MF, Katz PO, & Castell DO. (2001). Independent effects of fat, carbohydrate, and protein on lower oesophageal sphincter pressure and reflux in healthy volunteers… Aliment Pharmacol Ther, 11502091.
Q.
How long does acid reflux last?
A.
Most acid reflux episodes last 30 minutes to 2 hours, typically beginning 30 to 60 minutes after a trigger meal, and antacids can ease symptoms within minutes though relief may fade after 1 to 3 hours. If symptoms occur weekly or persist despite 2 to 4 weeks of over-the-counter treatment, it may be GERD that can last months to years without proper care. There are several factors and warning signs to consider, along with lifestyle and medication options that can shorten episodes; see below for complete details to guide your next steps.
References:
Vakil N, & van Zanten SV. (2006). The Montreal definition and classification of gastroesophageal reflux… Am J Gastroenterol, 16809175.
Dent J, El-Serag HB, Wallander MA, & Johansson S. (2005). Epidemiology of gastro-oesophageal reflux disease: a systematic… Gut, 15831924.
Gyawali CP, & Kahrilas PJ. (2018). Modern diagnosis of GERD: the Lyon consensus… Gut, 29263146.
Q.
What causes chest pain when breathing?
A.
Chest pain when breathing can be caused by a variety of conditions, ranging from musculoskeletal issues to serious respiratory or cardiovascular problems. Understanding the potential causes is crucial for proper diagnosis and treatment.
References:
Reamy BV, Williams PM, Odom MR. Pleuritic Chest Pain: Sorting Through the Differential Diagnosis. Am Fam Physician. 2017 Sep 1;96(5):306-312. PMID: 28925655.
Bösner S, Bönisch K, Haasenritter J, Schlegel P, Hüllermeier E, Donner-Banzhoff N. Chest pain in primary care: is the localization of pain diagnostically helpful in the critical evaluation of patients?--A cross sectional study. BMC Fam Pract. 2013 Oct 18;14:154. doi: 10.1186/1471-2296-14-154. PMID: 24138299; PMCID: PMC3853238.
Berliner D, Schneider N, Welte T, Bauersachs J. The Differential Diagnosis of Dyspnea. Dtsch Arztebl Int. 2016 Dec 9;113(49):834-845. doi: 10.3238/arztebl.2016.0834. PMID: 28098068; PMCID: PMC5247680.
Q.
What illnesses could cause upper stomach pain and nausea?
A.
Upper stomach pain accompanied by nausea can be caused by a variety of illnesses, including gastrointestinal disorders, infections, and other medical conditions. Common causes include gastritis, peptic ulcers, gallbladder disease, and pancreatitis. Understanding these potential causes is important for seeking appropriate medical evaluation and treatment.
References:
Murali N, El Hayek SM. Abdominal Pain Mimics. Emerg Med Clin North Am. 2021 Nov;39(4):839-850. doi: 10.1016/j.emc.2021.07.003. Epub 2021 Sep 10. PMID: 34600641; PMCID: PMC8430370.
Sherman R. Abdominal Pain. In: Walker HK, Hall WD, Hurst JW, editors. Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition. Boston: Butterworths; 1990. Chapter 86.
https://www.ncbi.nlm.nih.gov/books/NBK412/
Govender I, Rangiah S, Bongongo T, Mahuma P. A Primary Care Approach to Abdominal Pain in Adults. S Afr Fam Pract (2004). 2021 Mar 10;63(1):e1-e5. doi: 10.4102/safp.v63i1.5280. PMID: 33764143; PMCID: PMC8378095.
Q.
Why do I feel nauseous after I eat?
A.
Feeling nauseous after eating can be caused by various factors, including digestive disorders, food intolerances, and psychological issues. Identifying the underlying cause is important for effective management and relief.
References:
Scorza K, Williams A, Phillips JD, Shaw J. Evaluation of nausea and vomiting. Am Fam Physician. 2007 Jul 1;76(1):76-84. PMID: 17668843.
Harmon RC, Peura DA. Evaluation and management of dyspepsia. Therap Adv Gastroenterol. 2010 Mar;3(2):87-98. doi: 10.1177/1756283X09356590. PMID: 21180593; PMCID: PMC3002574.
Harer KN, Hasler WL. Functional Dyspepsia: A Review of the Symptoms, Evaluation, and Treatment Options. Gastroenterol Hepatol (N Y). 2020 Feb;16(2):66-74. PMID: 34035704; PMCID: PMC8132673.
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Link to full study:
https://www.medrxiv.org/content/10.1101/2024.08.29.24312810v1Richter, J. E., & Rubenstein, J. H. (2018). Presentation and epidemiology of gastroesophageal reflux disease. Gastroenterology.
https://www.sciencedirect.com/science/article/pii/S0016508517359772Gyawali, C. P., & Fass, R. (2018). Management of gastroesophageal reflux disease. Gastroenterology.
https://www.sciencedirect.com/science/article/pii/S0016508517359899Tack, J., & Pandolfino, J. E. (2018). Pathophysiology of gastroesophageal reflux disease. Gastroenterology.
https://www.sciencedirect.com/science/article/pii/S0016508517362480