Patient education

Reflux and heartburn

Name: Fifty 410
Address: US
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Because GLP-1 medications slow stomach emptying, some people notice acid reflux or heartburn. General information on meal habits, positioning, the medication categories to ask about, and when to call.

Why it can happen

When the stomach empties more slowly, food and acid stay in it longer and pressure can build. That can allow stomach contents to move up into the oesophagus, which is felt as heartburn or reflux.

Reflux that does not improve with everyday measures, or that comes with difficulty swallowing, vomiting, or chest pain, needs medical attention.

Everyday measures

General habits that many people find helpful. None of these replaces advice from your provider or pharmacist.

Smaller meals

Several smaller meals rather than large portions reduce stomach pressure.

Common triggers

Fried or fatty food, chocolate, caffeine, alcohol, citrus, tomato, mint, and very spicy food are frequent triggers.

Timing and posture

Finishing meals two to three hours before lying down and staying upright after eating.

At night

Raising the head of the bed and avoiding tight clothing around the abdomen.

Options to raise with your provider or pharmacist

Over-the-counter and prescription options exist in several categories. Ask which, if any, is appropriate for you and how to take it — this page does not give doses.

Antacids, for occasional symptoms. Antacids can affect the absorption of some other medications; a pharmacist can advise on spacing.
H2 blockers (for example famotidine).
Proton pump inhibitors (for example omeprazole), which are generally used under medical guidance.

Habits that may help

Chewing gum after meals increases saliva, which some people find soothing.
Not smoking.
Keeping a note of foods and timing that seem to trigger symptoms.

References

Katz PO, Dunbar KB, Schnoll-Sussman FH, Greer KB, Yadlapati R, Spechler SJ. ACG clinical guideline for the diagnosis and management of gastroesophageal reflux disease. Am J Gastroenterol. 2022;117(1):27-56. https://pubmed.ncbi.nlm.nih.gov/34807007/
Kaltenbach T, Crockett S, Gerson LB. Are lifestyle measures effective in patients with gastroesophageal reflux disease? An evidence-based approach. Arch Intern Med. 2006;166(9):965-971. https://pubmed.ncbi.nlm.nih.gov/16682569/
Nauck MA, Quast DR, Wefers J, Meier JJ. GLP-1 receptor agonists in the treatment of type 2 diabetes – state-of-the-art. Mol Metab. 2021;46:101102. https://pubmed.ncbi.nlm.nih.gov/33068776/