What to Expect: Acid Reflux on a GLP-1 and Why It Happens

GLP-1s have become a household name due to their impact on blood sugar and weight loss. But alongside the positive changes, many users report some unexpected side effects, namely, acid reflux. If you’re experiencing a burning sensation, regurgitation, or a persistent lump in the throat since starting a GLP-1, you’re not alone. And spoiler: we’ve created something that could help!

Let’s break down why this happens and what you can do about it.

Can GLP-1s Cause Acid Reflux?

Yes, GLP-1s can contribute to or worsen acid reflux symptoms in some people. In clinical trials, gastrointestinal side effects were among the most commonly reported issues, including nausea, bloating, constipation, and delayed gastric emptying (1). What often goes unnoticed, though, is the impact these GI changes can have on reflux.

Here’s the physiology behind it:

GLP-1s work by mimicking a hormone called glucagon-like peptide-1, which helps regulate blood sugar and appetite. One of its effects is slowing down the rate at which your stomach empties. 

While that’s helpful for blood sugar control and reducing hunger, it also means food stays in the stomach longer, and that can lead to more pressure on the lower esophageal sphincter (LES), the muscle that keeps stomach contents from flowing back up into the esophagus.

When that pressure increases, the LES is more likely to relax or open at the wrong time, allowing acid and digestive enzymes to sneak upward. That’s where reflux kicks in.

What Does Reflux Feel Like on a GLP-1?

Not everyone experiences the same symptoms, but the most commonly reported complaints include:

These symptoms can intensify more significantly in the early stages of treatment or after dosage increases, which aligns with our understanding of how GLP-1s affect gastrointestinal motility.

How Long Does Acid Reflux Last on GLP-1s?

There’s no universal timeline. For some people, reflux symptoms subside as their body adjusts to the medication. For others, especially those with a history of GERD or silent reflux (LPR), symptoms can persist or worsen over time. This is particularly true if other risk factors, like eating late, lying down soon after meals, or specific food triggers, aren’t being addressed.

If you’re dealing with prolonged symptoms, don’t ignore them. Chronic reflux can lead to inflammation, tissue damage, and, in rare cases, long-term complications like strictures or Barrett’s esophagus (2). It’s worth discussing with your healthcare provider solutions that support both your gastrointestinal function and your overall health.

Can You Take Omeprazole or Other Reflux Medications with GLP-1s?

In most cases, proton pump inhibitors (PPIs), such as omeprazole, can be taken in conjunction with GLP-1s to reduce stomach acid and manage reflux. Remember to always consult with your healthcare provider. But it’s important to note: PPIs only reduce acid; they don’t stop the backflow itself. That means if your reflux is due to mechanical or pressure-related issues from delayed gastric emptying, you may need additional tools.

Other options your provider might suggest include:

The Role of Alginates in Reflux Relief

One of the most effective yet underutilized tools for managing reflux, particularly when symptoms are caused by pressure or delayed gastric emptying, is alginate therapy.

RefluxRaft is an alginate-based product derived from brown seaweed that forms a protective “raft” on top of stomach contents. This barrier helps prevent acid and enzymes from flowing back into the esophagus or throat, whether the reflux is acidic or not. Unlike PPIs or H2 blockers, RefluxRaft doesn’t reduce acid production; it physically blocks the backflow at the surface.

Products like RefluxRaft can be taken as needed, even in combination with medications such as GLP-1 and omeprazole. They start working within minutes and are particularly helpful after meals or before bed, during the times when reflux tends to flare up most. It’s important to always consult your doctor before introducing a new supplement to your routine.

Tips to Minimize Reflux While on GLP-1

If you’re experiencing reflux symptoms while using GLP-1, here are some strategies to consider:

GLP-1s are powerful medications with real benefits, but like any treatment, they can come with trade-offs. If acid reflux has shown up since starting your prescription, you’re not imagining it, and there are effective ways to get relief.

From lifestyle adjustments to prescription support to natural therapies like alginates, you don’t have to choose between managing your weight or blood sugar and feeling good day to day. A holistic, informed approach can give you both.

Disclaimer: This article is for educational purposes only and is not intended to diagnose or treat any medical condition. Always consult your healthcare provider before making changes to your treatment plan.

Sources:

  1. Davies, M. J., et al. (2021). “Once-Weekly Semaglutide in Adults with Overweight or Obesity.” New England Journal of Medicine, 384, 989–1002.

  2. Richter, J. E. (2018). “Gastroesophageal Reflux Disease Treatment: Side Effects and Complications of Proton Pump Inhibitors.” Clinical Gastroenterology and Hepatology, 16(4), 465–472.

  3. Fass, R., et al. (2020). “Treatment of Gastroesophageal Reflux Disease: Lifestyle Modification and Medical Management.” Gastroenterology Clinics of North America, 49(2), 145–157.