How To Stop Acid Reflux on Ozempic
How do you stop acid reflux on Ozempic?
About 15 million adults in the US are currently taking GLP-1 class medications like Ozempic, Wegovy, Trulicity, Mounjaro, and others¹.
While heartburn isn't officially listed as a side effect of these drugs, plenty of people have flocked to social media and to their doctors to report acid reflux symptoms since starting their prescriptions.
So, if you're having heartburn, regurgitation, or similar symptoms that are interfering with sleep or your daily life, you're far from alone!
In this article I'll briefly explain:
Why acid reflux happens on Ozempic (and similar drugs)
Your options to calm you acid reflux
We'll also make sure to cover:
over-the-counter reflux medications you can use with Ozempic
lifestyle changes to manage symptoms
how you can address the root causes for long-term relief.
Why acid reflux happens on Ozempic
Acid reflux happens when the contents of the stomach flows backwards into the esophagus. When healthy, we have a one-way-valve that closes and prevents backflow.
Acid reflux happens when the valve is weak or opening inappropriately. The tender walls of your esophagus are then bathed in powerful acid which causes inflammation, irritation, and the trademark symptoms of heartburn, regurgitation, and more.
If you want a visual, watch the first part of my video on how acid reflux works here.
So what happens when Ozempic gets involved?
Well, Ozempic delays stomach emptying. This means the stomach contents stays in longer. It's part and parcel with the way the drug lowers blood sugar in diabetes and suppresses appetite for weight loss.
Unfortunately, every action has an equal and opposite reaction. The more time food spends in the stomach, the greater the risk of acid reflux.
This is not a new phenomenon. Foods that take longer to digest, other medications that delay stomach emptying, or health conditions that delay stomach emptying are all well-known predictors of acid reflux².
Having the acid bath lingering in your stomach for an unnatural amount of time, every time you eat... It's hard to imagine how that DOESN'T wear on your protective mucus lining over time. Your poor esophagus can only take so much!
How To Stop Acid Reflux
The guidance to manage acid reflux while on Ozempic should be the same as for those not on the drug.
You can avoid food triggers, make behavior modifications, take medications, use natural remedies, and strengthen the stomach valve. I'll do my best to go over all of them below.
Avoid Food Triggers
I rank dietary changes according to the tier list below. This should help you prioritize which changes to test/implement for yourself:
In the "Definitely Avoid" category, you have proven contributors to the root causes of acid reflux and its uncomfortable symptoms. These include...
Fatty, oily, fried foods
Carbonated beverages that increase pressure on the stomach
Alcohol
For common food triggers, you'll find:
Fatty foods (i.e. oils, fried foods)
Caffeine (i.e. coffee, tea, energy drinks)
Chocolate
Mint, especially peppermint
Spicy foods
Citrus (i.e. lemon, orange, pineapple)
Tomatoes
Allium vegetables (onions, leeks, garlic)
Food triggers have always been a spicy topic when it comes to acid reflux (pun intended). There's still debate on if or how these foods cause acid reflux symptoms. Some of these foods might increase acid in the stomach, some of them may just irritate an already inflamed esophagus, some may delay gastric emptying further, some may weaken your stomach valve... or multiple of the above. If you're curious about the debate, I cover it on my Youtube Channel here. Suffice it to say these food triggers are mostly based on anecdotal feedback from patients and every person's triggers are different.
It's also important to keep in mind that a combination of triggers can cause symptoms. Your symptoms may also be dose related... for example, when you eat a tiny dab of hot sauce versus a whole burrito-full of spicy chorizo. Make sure you keep a food log that includes how stressed you are, how much sleep you got, in addition to your actual eating details. This will help you identify your body's unique needs.
Foods I'd consider adding
Watery foods (watermelon, celery, cucumbers - water dilutes acid)
Dairy (non-fat milk, yogurt may chemically buffer acid, but can also be triggers!)
Generally speaking, more fiber foods like fruits and vegetables should aid in overall digestive health and reduce symptoms.
Behavior Modifications
There's a few easy steps you can take to help reduce symptoms:
Eat more frequent, smaller meals (stretching your stomach less = less reflux)
Wear looser clothing (less pressure on abdomen = less reflux)
Don't eat within 3-4 hours of going to bed (stomach empty when you lie down)
Elevate your bed or body during sleep (use gravity to help keep acid in stomach)
Don't exercise on a full stomach (less sloshing = less reflux)
Drink more water (dilutes acid)
Reduce or stop drinking carbonated beverages
Basically, any time you lie down with contents in your stomach, you encourage reflux because gravity is no longer holding food down. Don't just prop your head up - make sure your whole torso is angled so gravity can help stop acid reflux. You can prop up the head of your bed or use a wedge pillow to get this effect.
Anything that puts pressure on the stomach (like big meals or tight clothing) will encourage reflux. Remember that when on Ozempic, your stomach empties slower than usual, so adjust these guidelines accordingly.
Medications
There's three main classes of acid reflux medications. There are no interactions between Ozempic and these drugs, according to Ozempic's clinical trials³. As always, consult your doctor on your unique situation.
Antacids
These are over-the-counter pills you can take to quickly reduce acid reflux symptoms. They work because they are chemical buffers that counteract your stomach acid to make it less potent/damaging to the esophagus. Some common brand names are:
Alka-Seltzer
Tums
Pepto-Bismol
Rolaids
Mylanta
I'd also add to this tier the meds that form a protective coat over the esophagus.
H2 Blockers
These are the old-generation prescription acid reflux meds. Available over-the-counter in smaller doses, they work by reducing acid production in the stomach. Brand names include:
Axid (nizatidine)
Pepcid (famotidine)
Tagamet (cimetidine)
Proton pump inhibitors (PPIs)
These are the newer generation meds for acid reflux. Some are available over-the counter but some are prescription strength and available from your doctor. PPIs also work by reducing acid production in the stomach. Brand names include:
Prilosec (omeprazole)
Nexium (pantoprazole)
Protonix (pantoprazole)
For short-term, periodic symptom relief, these drugs are very effective. The main downsides to these meds come from chronic, long-term use.
Weaker stomach acid may make it harder for your body to break down and absorb essential nutrients like calcium, folic acid, B12, and more⁴. Long-term use has been associated with increased bone fracture potentially due to poorer nutrient absorption⁵. There is also a documented rebound effect⁶ when stopping some of these meds after prolonged use, making it difficult to get off the meds.
It also may reduce the natural germ-killing properties of your stomach acid, which has been associated with increased C-diff infections⁷ and Small Intestine Bacterial Overgrowth (SIBO)⁸.
So, if I was using them for longer that 4-8 weeks, I'd consider a discussion with my doctor. Please use your own judgement for your case.
Meds to avoid
You should limit the use of Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) like ibuprofen and aspirin.
Full list of medicines that can cause/worsen acid reflux are here, if you're interested. If you are taking something on that list, it could be causing the reflux in combination with Ozempic.
Natural Remedies
You may prefer trying some of these herbal approaches before trying medications. There's not a ton of research proving the effectiveness, but it could be a huge win if one of these works for you.
Ginger. Has long been used as a digestive aid. Try using it in a tea.
Chamomile. Also known to have digestive properties. Try using it in a tea.
Tumeric. Has anti-inflammatory properties, which may work to assist healing of a damaged esophagus. You can take a supplement, but cutting a quarter inch off the root and ingesting works just as well. You can also add it as a natural spice in cooking.
Licorice. Known for various digestion-improving properties, may strengthen the protective mucus lining of the esophagus to reduce acid reflux symptoms. Use the Deglycyrrhizinated Licorice Root version because Glycyrrhizin may raise blood pressure⁹, increase fluid retention, and/or lower potassium levels.
Fix The Root Cause
It may seem like your acid reflux is happening because of Ozempic, and it is - but the deeper root cause is that your stomach valve is not doing its job. It may be that the medication caused a change that exposed a reflux problem that was in development.
It behooves me to talk about how to strengthen the stomach valve, because it's not talked about enough and it's an important part to beating acid reflux naturally with my students. If your stomach valve worked better, you could take Ozempic without heartburn or reflux; you'd be less dependent on reflux meds to manage symptoms; and you wouldn't have to worry so much about avoiding food triggers.
To strengthen your valve:
Shed excess weight. Excess weight causes more pressure on the stomach, which wears out your stomach valve over time. If you are on Ozempic for weight loss, you're already on a path to resolve this :)
Reduce fatty foods. Yes, they are above as well. That should tell you how important they are to avoid! They both relax your stomach valve and slow down your digestion further. This slowing effect does not pair well with Ozempic's slower stomach emptying.
Reduce or stop drinking alcohol. Alcohol interferes with the signaling to your stomach valve, causing it to relax.
Reduce or stop smoking. Smokers have weaker stomach valves than non-smokers. Chronic coughing and deep inhales can also cause more pressure on the stomach over time. If that weren't enough, smoking has also been shown to inhibit the production of natural chemical buffers in your saliva, reducing protection to the esophagus.
Resolve other digestive issues. Chronic constipation and bloating both build pressure in the abdomen, causing strain on your stomach valve and wearing it out over time.
De-stress. Just like some people clench their jaw when stressed, you may hold the stress in your abdomen. If your abdominal muscles are tense due to stress, the increased pressure can weaken your stomach valve.
Mind the gut-brain axis. There is a strong connection between emotions and digestion and vice versa. You may notice more reflux symptoms when angry, frustrated, depressed, stressed, or anxious. These emotions can cause the valve to open inappropriately. Delayed stomach emptying due to Ozempic just makes reflux even more likely and can disrupt the microbiome in the gut.
Consider structural effects. In the case of hernia (especially hiatal hernia) the structure that supports your stomach valve has been compromised, meaning the valve will not be as strong. This leads to more reflux.
Conclusion
So there you have it. To manage acid reflux while on Ozempic:
Avoid food triggers
Make behavioral modifications
Consider medication
Consider herbal approaches
To stop acid reflux while on Ozempic, you'll have to consider bigger lifestyle overhauls to get to the root causes to stomach valve malfunction. Your Ozempic treatment period may be over before further intervention is needed.
If you want to learn more about lasting solutions to these root causes, I recommend you download my Ultimate Guide to Acid Reflux. It's currently free and will provide a comprehensive approach to resolving the root causes of reflux through lifestyle. It goes as detailed as providing the step by step dietary changes and examples to boot. You can download it here >>
Finally, if this article helps you, I'd love you to shoot me a quick email letting me know. Your success is why I write! You can send an email to Hello@TheRevitalizeCenter.com.
Dylan
Dylan is a lifelong health nut who turned his passion into a holistic health practice, Revitalize Wellness Center. There he has helped hundreds of people in his hometown of Sacramento to reverse chronic health issues, lose weight, get off medications, and regain their youthful energy and vibrance for life. He believes that the epidemic of illness, obesity, and depression is not part of our natural aging process and is 100% avoidable through proper education. The continued, long-term success of his practice members motivate him and serve as proof that chronic health issues don't have to be your destiny. He now writes articles and creates videos online for people to get the education he wished his parents had.
Citations
15 million Americans are on weight loss drugs - Kaiser Family Foundation 2024 Survey
Heartburn as a symptom of gastroparesis - Houston Heartburn and Reflux Center
Ozempic label and prescribing information - FDA
Weaker stomach acid may hinder nutrient absorption - National Institutes of Health
PPI use and bone fracture - National Institutes of Health
Rebound effects after acid suppressing medicine - New Zealand Medicines and Medical Devices Safety Authority
PPI use and Cdiff infections - National Institutes of Health
PPI use and SIBO - National Institutes of Health
Licorice may increase blood pressure - Harvard Business Review
