When things “leave a bad taste in your mouth,” they have made a negative impression. (And let’s be honest, we could say that every GERD symptom has made a negative impression on us, right?) But if you suffer from water brash, the bad taste in your mouth is an actual symptom—not an idiom. Never heard of it? Here’s what you need to know about this less-common symptom of gastroesophageal reflux disease (GERD).
What Is Water Brash?
Sometimes called hypersalivation, acid brash, or pyrosis idiopathica, water brash is characterized by a large amount of saliva in the mouth along with a sour or acidic taste. GERD most often causes it. A hiatal hernia—when part of the stomach pushes up to the chest through an opening in the diaphragm—may also cause water brash (as well as contribute to the development of GERD).
What Causes Water Brash?
Water brash doesn’t happen in everyone with GERD or heartburn. Some people are prone to producing extra saliva in response to the arrival of stomach acid in the esophagus. This happens via the “esophago-salivary reflex” and presumably is a protective mechanism to help the body defend itself against esophageal irritation caused by stomach acid returning. And indeed, a small study showed that the increased saliva did help clear the refluxed acid from the esophagus.
What Does Water Brash Feel Like?
Having acid reflux or heartburn feels like a burning sensation in your chest, varying from mild to severe. Some people liken water brash to heartburn, but it occurs in the throat. If you have GERD, you may or may not experience heartburn as one of your symptoms, but you could still have water brash. Other people describe water brash just as a distinctly sour taste in the mouth or an acid taste in the back of the throat—aspects that make it seem like regurgitation. However, regurgitation in GERD doesn’t involve extra saliva production, and regurgitation is considered more common than water brash.
How Is Water Brash Treated?
Although unpleasant, water brash isn’t something you would typically seek treatment for on its own unless it happens frequently (which it sometimes does). If it happens more often, or if you’ve had GERD for a while and suddenly start having water brash, you may want to notify your doctor. Because water brash can occur alongside GERD, managing the underlying reflux may help reduce episodes.
Treatment may include individualized lifestyle changes, medications, or further evaluation depending on symptom frequency and severity. Baking soda is a home remedy that can be dangerous, so check with your doctor before trying to treat water brash on your own.
Treatment may include individualized lifestyle changes, medications, or further evaluation depending on symptom frequency and severity. Baking soda is a home remedy that can be dangerous, so check with your doctor before trying to treat water brash on your own.
The Bottom Line on Water Brash and GERD
Water brash can be annoying and unpleasant, but it’s not terribly serious. The key is that managing your GERD is the best way to eliminate water brash. If your GERD symptoms are not responding to the lifestyle management techniques you’ve been using or to prescribed medication, make an appointment to discuss your situation with your physician. Continued irritation of the esophagus can lead to other problems that can be serious.
FAQs
Is water brash the same as acid reflux?
Not exactly. Water brash is a symptom that can occur with acid reflux or GERD. It involves a sudden increase in saliva production, sometimes accompanied by a sour or acidic taste in the mouth. Acid reflux refers to stomach contents flowing back into the esophagus, while water brash describes a salivary response that may accompany reflux.
Can you experience water brash without heartburn?
Yes. Not everyone with GERD experiences noticeable heartburn, and symptoms can vary considerably. Water brash may occur alongside regurgitation, an acidic taste, or other reflux-related symptoms. However, excessive salivation alone does not confirm GERD, since other conditions can also cause increased salivation.
How can I stop water brash from happening?
Managing the underlying reflux may help reduce water brash episodes. Strategies can include eating smaller meals, avoiding lying down for two to three hours after eating, and identifying personal food or beverage triggers. Depending on symptom frequency and severity, your healthcare provider may also recommend medication or additional evaluation.
When should I see a doctor about water brash?
Occasional water brash may not require specific treatment, but frequent or worsening episodes deserve medical attention, especially if you also experience persistent reflux symptoms. Seek prompt medical evaluation for difficulty swallowing, painful swallowing, unexplained weight loss, or persistent vomiting. These symptoms may indicate a condition requiring further investigation.
References
1Yadlapati, R., Gyawali, C. P., & Pandolfino, J. E. (2022). AGA clinical practice update on the personalized approach to the evaluation and management of GERD: Expert review. Clinical Gastroenterology and Hepatology, 20(5), 984–994.e1. https://doi.org/10.1016/j.cgh.2022.01.025
2Helm J. F. (1986). Esophageal acid clearance. Journal of clinical gastroenterology, 8 Suppl 1, 5–11. https://doi.org/10.1097/00004836-198606001-00003
3Harvard Health Publishing. (2023, July 18). What is a hiatal hernia? https://www.health.harvard.edu/diseases-and-conditions/what-is-a-hiatal-hernia
4Shafik, A., El-Sibai, O., Shafik, A. A., & Mostafa, R. (2005). Effect of topical esophageal acidification on salivary secretion: identification of the mechanism of action. Journal of gastroenterology and hepatology, 20(12), 1935–1939. https://doi.org/10.1111/j.1440-1746.2005.04005.x
Recipes
Products
Comments
Join The Conversation...