Acid reflux and heartburn (GORD): Questions and Answers

Want the full picture of why reflux happens? what causes acid reflux.

Written and reviewed by Dr Ali Zad, FRACP gastroenterologist, Brisbane. Last reviewed November 2026 against current Australian and international guidelines. General information only, not a substitute for personal medical advice.

What is GORD?

Gastro-oesophageal reflux disease (GORD) happens when stomach acid and contents flow back up into the oesophagus often enough to cause symptoms or damage. Common symptoms are heartburn, a sour taste, regurgitation, chest discomfort, cough or a hoarse voice. Occasional reflux is normal; frequent or troublesome reflux is GORD.

When should I see a specialist about reflux?

See your GP or a gastroenterologist if reflux happens more than twice a week, does not settle with treatment, or comes back when you stop medicines. Seek prompt review for warning signs: difficulty or pain swallowing, vomiting, black stools, unexplained weight loss, iron deficiency, or new reflux after the age of 50.

What lifestyle changes help reflux?

Helpful steps include losing excess weight, avoiding large or late meals (finish eating 3 hours before bed), raising the head of the bed, cutting back on alcohol and smoking, and reducing foods that trigger your symptoms, such as fatty or spicy meals, chocolate, coffee or fizzy drinks.

Is it safe to take reflux tablets long term?

Proton pump inhibitors (PPIs) such as esomeprazole or pantoprazole are effective and generally safe when there is a clear reason to take them. Your doctor should review the lowest effective dose regularly. Do not stop suddenly after long-term use, as symptoms can rebound; reduce gradually with medical advice.

What tests are used to investigate reflux?

A gastroscopy checks for inflammation, Barrett’s oesophagus or a hiatus hernia. If symptoms continue or surgery is being considered, 24-hour pH impedance monitoring or Bravo wireless pH testing measures reflux directly, and oesophageal manometry checks how the oesophagus works.

Can reflux happen without heartburn?

Yes. This is sometimes called silent reflux or laryngopharyngeal reflux. It can cause a chronic cough, hoarse voice, frequent throat clearing, a lump-in-the-throat feeling or worsening asthma, often without classic heartburn.

Why is my reflux worse at night?

Lying flat makes it easier for stomach contents to flow back into the oesophagus, especially after a large or late meal. Finishing dinner at least 3 hours before bed, raising the head of the bed by 15 to 20 cm and sleeping on your left side can help.

Can stress make reflux worse?

Stress does not usually cause reflux, but it can make the oesophagus more sensitive so symptoms feel stronger. Managing stress, regular sleep and exercise can reduce how much reflux bothers you.

Is reflux surgery an option?

Anti-reflux surgery (fundoplication) or endoscopic procedures may suit people with confirmed reflux who do not respond to or do not want long-term medicines. Testing with gastroscopy, pH monitoring and manometry is needed first to make sure surgery is the right choice.

Can I have reflux tests while taking PPIs?

It depends on the question being answered. If reflux has not yet been proven, PPIs are stopped for 7 days before pH or Bravo testing so the true amount of acid reflux can be measured. If reflux is already proven and symptoms continue despite treatment, testing may be done while still taking PPIs. Your specialist will advise which applies to you.

Guideline: Lyon Consensus 2.0 for GORD testing (2024).

Related procedures and information

• 24-hour pH monitoring with Dr Ali Zad
• Gastroscopy with Dr Ali Zad
• Bravo wireless pH test with Dr Ali Zad
• All digestive health questions and answers
• Patient education videos

Book an appointment

If you have symptoms of acid reflux and heartburn, see your GP or book a consultation with gastroenterologist Dr Ali Zad on (07) 2111 2600 or request an appointment online. You can book directly; a GP referral is needed for a Medicare rebate.

Dr Zad consults and performs procedures across Brisbane and Moreton Bay: Brisbane City and Spring Hill, North Lakes, Caboolture, Everton Park, Taringa and Redcliffe and Kippa-Ring.