The Science of Water and GERD: Understanding the Connection
Put down your water bottle; you’ve got to read this.
Drinking more water is always mentioned as one of the best things we can do for our bodies and health. And nobody denies that good old H2O is the way to go when looking for healthy hydration options. As a dietitian, I’ve coached numerous people into drinking more water.
But then, this summer, I noticed something about my own water drinking. It was having an unwanted impact on my body—specifically, it was giving me heartburn. This happened mostly at night but also during the day sometimes. This baffled me as I’d never heard of drinking water leading to heartburn. Let’s dive into what the science says about a link between water drinking and GERD.
Water and digestion
When you eat, hydrochloric acid is released into your stomach to help the food break down. This creates an acidic liquid that can sometimes back up into the esophagus and cause GERD symptoms. Food digestion can take several hours to a day or longer, depending on the composition of the food and individual factors. However, the water we drink is typically absorbed quickly since the body doesn’t have to do much for it to be absorbed. In fact, when there is no food in the stomach, any water consumed can be absorbed in as little as 5 minutes.
On the other hand, when food is also present or consumed along with the water, such as when we drink water with a meal, it takes longer to absorb the water. For example, other liquids, such as juice or milk, will take longer to digest than plain water because of their different components. Nevertheless, drinks are still more quickly handled than solid food.
Does water cause reflux symptoms?
Drinking plain water does not cause heartburn or other GERD symptoms for most people. In fact, replacing beverages that are typically associated with acid reflux, such as coffee, tea, or soda, with water can be an effective way for some individuals to reduce their symptoms. There is even an indication that drinking alkaline water may help reduce hydrochloric acid’s effects on the body, leading to improvements in acid reflux, although more research on that is needed.
Carbonated water, like seltzer, can contribute to reflux symptoms for some people. Drinking plain water does briefly decrease the acidity of the stomach contents, but there’s no scientific evidence that this improves GERD or acid reflux.
So why was I experiencing heartburn after drinking water? It turns out that it might have something to do with my water-drinking habits…
Water and stomach distension
You’re probably familiar with the fact that eating large meals, especially at night, can trigger reflux symptoms. And although you might have trigger foods, sometimes it’s not just what you’re eating, but how much. Eating a big meal or having a full stomach in general leads to gastric distension and a bloated feeling. And it’s not just food that causes stomach distension; water does it, too.
Research shows that gastric distension increases the exposure of the lower esophageal sphincter to acidic stomach contents—not to mention forcing the acidic gastric juices to come back up into the esophagus. Some studies have shown that people with frequent heartburn, bloating, and acid reflux (sometimes called functional dyspepsia) aren’t able to drink as much water as people without these issues.
What’s more, these folks become bloated, and experience increased abdominal pressure and feelings of fullness earlier than others. Sound familiar to you? It does to me. As good as water is for you, it’s apparent that drinking a lot of water at once will make the distension worse. The same goes for drinking water during a meal.
How to handle your water if it causes you symptoms
Nobody would suggest that people with GERD or reflux stop drinking water. It’s the ideal beverage for bodily health. So what can be done? I’ve learned a few things that have helped me, including:
- Space your water drinking throughout the day. I found that most of the time, I drank water mainly in the morning and then again at night. I hadn’t realized that I was skimping on the water during the larger part of the day; hence, I was pretty thirsty come dinnertime. My lesson: don’t wait until the evening to compensate for not drinking enough water during the day.
- Sip water instead of guzzling it. Having sips of water regularly versus downing an entire bottle or big glass at once helps you hydrate without creating stomach discomfort.
- Experiment with cutting back on beverages during meals and consuming most of your liquids between meals. Minimizing drinks during meals can help prevent them from taking up too much volume in the stomach. Keeping mealtime beverages in check also will allow for better nourishment because you’ll be more likely to finish your meal.
- Keep in mind that seltzer or other carbonated beverages can trigger symptoms, so avoid them if necessary.
- Péronnet, F., Mignault, D., du Souich, P., Vergne, S., Le Bellego, L., Jimenez, L., & Rabasa-Lhoret, R. (2012). Pharmacokinetic analysis of absorption, distribution and disappearance of ingested water labeled with D₂O in humans. European journal of applied physiology, 112(6), 2213–2222.
- Mehta, R. S., Song, M., Staller, K., & Chan, A. T. (2020). Association Between Beverage Intake and Incidence of Gastroesophageal Reflux Symptoms. Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 18(10), 2226–2233.e4.
- Koufman, J. A., & Johnston, N. (2012). Potential benefits of pH 8.8 alkaline drinking water as an adjunct in the treatment of reflux disease. The Annals of otology, rhinology, and laryngology, 121(7), 431–434.
- Karamanolis, G., Theofanidou, I., Yiasemidou, M., Giannoulis, E., Triantafyllou, K., & Ladas, S. D. (2008). A glass of water immediately increases gastric pH in healthy subjects. Digestive diseases and sciences, 53(12), 3128–3132.
- Ayazi, S., Tamhankar, A., DeMeester, S. R., Zehetner, J., Wu, C., Lipham, J. C., Hagen, J. A., & DeMeester, T. R. (2010). The impact of gastric distension on the lower esophageal sphincter and its exposure to acid gastric juice. Annals of surgery, 252(1), 57–62.
- van den Elzen, B. D., Bennink, R. J., Holman, R., Tytgat, G. N., & Boeckxstaens, G. E. (2007). Impaired drinking capacity in patients with functional dyspepsia: intragastric distribution and distal stomach volume. Neurogastroenterology and motility, 19(12), 968–976.
- National Institute of Diabetes and Digestive and Kidney Disease (2016, November). Definition and Facts of Indigestion. National Institutes of Health. Retrieved Aug 22, 2023.
Comments
Joanne
03/11/2025 at 09:18 AM
I have heartburn bad twenty four seven but I feel like water makes it even worse. Why
Kitty Broihier, MS, RD
03/11/2025 at 09:18 AM
Hi Darlene, thanks for your comment. It’s unlikely that dilution of stomach acid with water is the issue, I’ll admit, however, that there is a lack of research on this exact topic. Water itself does not trigger acid production and any impact on gastric ph is minor and short-term since water is absorbed in about 5 minutes. Nevertheless, I always say that people know their bodies best. In cases like these, sometimes it’s best to simply learn to manage the condition. Drinking smaller amounts of water (maybe half a cup would work better than 1 cup for you) more frequently might be the answer. Or, consider whether the water you are drinking is being consumed quickly (such as after a workout) or with food (where it can contribute to stomach distension that may trigger heartburn).
Kitty Broihier, MS, RD
03/11/2025 at 09:18 AM
Hi Bee, thanks for your comment. Have you considered the conditions under which you are drinking water vs the other beverages? Beverages consumed with meals tend to increase the risk of heartburn vs beverages consumed between meals—no matter what the beverage is. Just an idea, but perhaps play around with the time of day you are drinking water, and how that relates to your eating schedule.
Kitty Broihier, MS, RD
03/11/2025 at 09:17 AM
Suzi, thanks for your comment. It seems you’ve done a lot of self-experimentation and know your body well. I’m glad you’ve found a way to determine how to adjust your food and water intake to accommodate your condition. Have you checked out my post on hypochlorhydria here on the FoodGuides website? Here’s the link: https://foodguides.com/blogs/from-the-experts/low-stomach-acid-interventions-for-optimal-digestion?pos=1&_sid=5f03530bd&ss=r
Kitty Broihier, MS, RD
03/11/2025 at 09:17 AM
Danny, thanks for your comment. It’s out of my scope as a dietitian to answer individual health questions like yours in any depth, so I cannot really speak to how you might solve your issue. However, from the comments on this post, it’s apparent that heartburn from drinking water is definitely a “thing”! Offhand, I’d suggest considering how stomach distension might be playing into your condition. You say you drink “a lot” of tea, so is your stomach already distended when you add in the water? Another practical step you might consider: divide your water intake into smaller amounts consumed more frequently and see how that impacts you.
Danny
03/10/2025 at 10:04 AM
I drink a lot of tea and Diet Mt. Dew, and never get heartburn from these. But one glass of pure water causes me heartburn for the entire day. How can I correct this?
Suzi
03/10/2025 at 10:08 AM
Realize that too much stomach acid has the same symptoms as not enough. Too much acid will come up in your esophagus, not enough acid and your sphincter relaxes and acid comes up. How do you know? Next time you get acid reflux, drink some baking soda and water… If your symptoms keep coming back (it takes mine 30 minutes or longer), try a little vinegar and water… If your symptoms goes away, you have heartburn because of low acid. The vinegar added acid and your sphincter closed up. My stomach acid must be very close to my sphincter’s requirements as sometimes I have heartburn because of too much acid snd sometimes it’s because I don’t have enough acid. Adding water must tip the balance for me. Thanks for your article, it helped me accept my condition and I’ll be adjusting the pH of my water to see if that helps. Thanks again.
Bee
01/31/2025 at 12:21 PM
I have the same water starts off my acid reflux no matter how slowly I sip it but yea coffee and milk don’t effect me
Darlene
12/30/2024 at 09:47 AM
Okay this isn’t me. I never have heartburn unless I drink water. Is it possible that the dilution of my stomach acid with water causes it overproduction of stomach acid? If I drink acidic drinks like soda tea coffee etc I don’t have any problem and I can drink gallons but if I drink an 8 oz glass of water straight water, I have heartburn within 15 minutes. Have you ever heard of this? Does it have a name?
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