Water Brash: When GERD Leaves a Sour Taste in Your Mouth

The Hidden Symptom: What You Need to Know About Water Brash and GERD

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 who has GERD or experiences 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 is located in their throats. 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.  

Is there a treatment for water brash?

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 you are experiencing it more often, or if you’ve had GERD for a while and suddenly start having water brash as well, you may want to notify your doctor. However, since water brash is generally a result of GERD, any treatment that helps decrease or manage GERD will likely help reduce water brash episodes. Taking baking soda is a home remedy that can be dangerous, so check with your doctor before tackling water brash on your own.

Bottom line:

Water brash can be annoying and unpleasant, but it’s not terribly serious. The important thing to keep in mind is that managing your GERD is the primary strategy 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.  

1. _{Helm J. F. (1986). Esophageal acid clearance. Journal of clinical gastroenterology, 8 Suppl 1, 5–11. https://doi.org/10.1097/00004836-198606001-00003}
2. _{What is a hiatal hernia? Harvard Health Publishing, Harvard Medical School. (July 18, 2023). Retrieved September 17, 2023 from https://www.health.harvard.edu/diseases-and-conditions/what-is-a-hiatal-hernia}
3.  _{Shafik, 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}
4. _{Kahrilas P. J. (2013). Regurgitation in patients with gastroesophageal reflux disease. Gastroenterology & hepatology, 9(1), 37–39. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3975977/}

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