How to minimize acid reflux on a GLP-1

If you’ve ever had acid reflux, you’re familiar with that burning hot feeling in your chest or throat — or worst of all, the “throw-up burp.” Unfortunately, G.I. symptoms, including acid reflux, are common side effects of GLP-1 medications. Research indicates this could result from slower stomach emptying on a GLP-1.

Imagine your esophagus, a long tube starting in your throat that’s responsible for transporting what you eat and drink down to your stomach. At the other end of the esophagus is a band of muscle, which acts as the entrance to the stomach, and is only supposed to open when you’re eating or drinking — and when it opens at other times, that’s when stomach acid can come up into your esophagus.

Usually heartburn is mild and temporary; if it happens frequently or severely, you may have gastroesophageal reflux disease (GERD), which sounds intense but is a manageable condition.

It used to be that doctors recommended completely cutting a laundry list of foods from your life if you had reflux: chocolate, spicy foods, highly acidic foods (such as oranges and tomatoes), and anything with a high fat content. But research has since shown that everyone reacts to ingredients differently, so there isn’t a gold-standard eating pattern that everyone should follow.

To help you identify what exacerbates your symptoms, try keeping a food diary for a week, says Tripp Buckley, M.D., surgical director of digestive health at U.T. Health Austin and Ascension Seton. You can easily do this by logging your food in the Weight Watchers app, so you can see if certain foods are triggering your symptoms. Once you’ve figured out your triggers, you can choose to limit them.

For some folks, lying down allows stomach contents to spill backward, making sleep challenging. It may help to stop eating at least three hours before bedtime to prevent nighttime reflux. It also may help to sleep at an incline, so the acid has a harder time coming up your esophagus; try propping up your head with extra pillows or wedge-shaped foam.

None of these are fun or easy to give up, but they can make a big difference. That’s because these substances can prompt reflux by relaxing the band at the bottom of your esophagus, making it leak acid.

If you just have occasional reflux, says Buckley, you may get enough relief by chewing a calcium carbonate antacid like TUMS or Rolaids, which neutralize stomach acid in the moment.

For more frequent or severe reflux, try proton pump inhibitors (PPIs) like Prilosec and Nexium, which are available over the counter or a stronger version by prescription. They help decrease reflux by preventing cells in the stomach from producing too much acid, so they work well, but the relief isn’t immediate. They take about two to three days to get into your system, Buckley says, and you need to take them every day for them to stay effective.

Learn about other G.I. GLP-1s side effects — and how to treat them