How to Stop GLP-1 Heartburn and Acid Reflux
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Time to read 4 min
GLP-1 medications have transformed the treatment of type 2 diabetes and obesity. But for many patients, they come with an uncomfortable side effect: heartburn and acid reflux. This article explores why GLP-1 drugs may cause acid reflux and offers clear, scientifically grounded strategies to manage symptoms while staying on track with your treatment plan.
Disclaimer: The information provided in this blog post is for general knowledge and informational purposes only, and does not constitute medical advice. Always consult with a qualified healthcare professional before making any decisions about your health or treatment. If you experience persistent or severe acid reflux, seek medical attention immediately.
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Table of contents
Why GLP-1 Medications Can Cause Acid Reflux 1. Delayed Gastric Emptying 2. Increased Intragastric Pressure 3. Reduced Meal Frequency and Larger Portions How to Manage Heartburn and Acid Reflux on GLP-1 Therapy 1: Adjust Meal Size and Timing 2: Avoid Trigger Foods and Beverages 3: Stay Upright After Meals 4: Sleep with Head Elevation 5: Take Antacids or Acid-Suppressing Medications Key takeaways
Why GLP-1 Medications Can Cause Acid Reflux
As a hormone, GLP-1 is released after eating and helps regulate blood sugar and appetite. As a medication (GLP-1 receptor agonists), it mimics the hormone's effects to treat type 2 diabetes and, increasingly, for weight loss. This includes semaglutide (Ozempic, Wegovy), liraglutide (Victoza, Saxenda), and tirzepatide (Mounjaro). This slows gastric emptying, suppresses appetite, and improves blood glucose control.
However, slowed digestion can increase pressure inside the stomach, raising the risk of acid reflux - especially in those with a history of GERD, hiatal hernia, or weakened esophageal tone.
1. Delayed Gastric Emptying
GLP-1 drugs significantly slow the movement of food from the stomach to the small intestine. This delay can lead to gastric distension, increased pressure against the lower esophageal sphincter (LES), and a higher likelihood of stomach acid entering the esophagus.
2. Increased Intragastric Pressure
As the stomach remains full for longer, pressure builds within the gastric cavity. This pressure can overcome a relaxed LES, especially in individuals with pre-existing reflux or weakened esophageal tone, leading to heartburn and regurgitation.
3. Reduced Meal Frequency and Larger Portions
Because GLP-1 suppress appetite, many patients eat less frequently but in larger volumes when they do eat. Large meals contribute to delayed emptying and may directly trigger acid reflux, especially when consumed quickly or before lying down.
How to Manage Heartburn and Acid Reflux on GLP-1 Therapy
Before making any changes, discuss persistent symptoms or severe discomfort with your prescribing healthcare provider. Adjustments to dosage, timing, or alternative therapy may be appropriate.
1: Adjust Meal Size and Timing
Eat smaller, slower meals, ideally spread throughout the day.
Avoid eating within 2-3 hours of lying down.
Refrain from drinking large amounts of fluid during meals.
This approach reduces pressure on the stomach and minimizes acid reflux episodes.
2: Avoid Trigger Foods and Beverages
Certain foods are more likely to worsen acid reflux during treatment. These may include:
Citrus fruits and juices
Tomato-based sauces
Chocolate
Fried or fatty foods
Carbonated beverages
Caffeinated drinks
Peppermint
Instead, focus on:
Lean proteins (chicken, fish, tofu)
Non-citrus fruits (bananas, melons)
Cooked vegetables
Oatmeal or whole grains
Image from Osmosis. (From Elsevier)
If you're unsure what your triggers are, consider keeping a food and symptom diary to track your reactions over time. You can also take Claisen’s free quiz for personalized insights into your gut health.
3: Stay Upright After Meals
Avoid reclining or lying down for at least 2-3 hours after eating, as this gives gravity time to assist digestion and prevents acid from moving upward into the esophagus.
4: Sleep with Head Elevation
If you experience nocturnal reflux, try elevating the head of your bed by 6-8 inches or using a wedge pillow. This positioning can significantly reduce acid backflow during sleep.
5: Take Antacids or Acid-Suppressing Medications
Over-the-counter (OTC) and prescription drugs are available to treat acid reflux that work either by suppressing the production of stomach acid or neutralizing stomach acids. Common options include:
Calcium carbonate (e.g., Tums)
Alginate-based agents (e.g., Gaviscon)
H2 blockers (e.g., famotidine)
Proton pump inhibitors (PPIs) (e.g., omeprazole)
Important: Always consult your prescribing physician before adding any medication, as drug interactions and timing (especially with semaglutide) need to be carefully managed.
Key takeaways
GLP-1 medications slow gastric emptying and may increase the risk of heartburn and acid reflux.
Smaller, slower meals and upright posture after eating can help prevent symptoms.
Avoid common dietary triggers and consider sleep modifications if reflux occurs at night.
Reflux symptoms can often be managed without discontinuing GLP-1 therapy.
Ready for personalized relief for acid reflux? Complete Claisen's gut health quiz to identify your unique reflux triggers and receive evidence-based recommendations tailored to your digestive profile.
Is heartburn a common side effect of Ozempic or Wegovy?
Yes. Heartburn and other GI issues like nausea and bloating are known side effects of semaglutide-based medications. These often improve with time or symptom management strategies.
Can I take PPIs or antacids while on a GLP-1 drug?
Possibly, but always under medical supervision. Some acid-reducing medications can affect absorption or interact with your treatment, so coordination with your prescribing provider is essential.
Will heartburn go away once my body adjusts?
In many cases, yes. Mild GI symptoms often improve after the first few weeks of GLP-1 therapy. If not, dietary changes and supportive medications may be needed.
Should I stop my GLP-1 if I have heartburn?
No. Do not stop any prescribed medication without consulting your doctor. Reflux symptoms can usually be managed with lifestyle adjustments or adjunctive therapy.
