Dietitian warns the way you drink water can worsen acid reflux

Registered dietitian Molly Pelletier told her Instagram followers that the way people drink water can aggravate acid reflux symptoms, warning that large gulps with meals or very cold water on an empty stomach may trigger heartburn, throat clearing, bloating or regurgitation.

Pelletier, who describes herself as an acid reflux specialist and has more than 64,000 followers, wrote that "it's not just what you drink but how and when that matters," and said she sometimes wondered what her life would have been like if she had realized earlier that her drinking habits were making symptoms worse. She added that while water is healthier than sugary soft drinks, simply switching beverages is not guaranteed to eliminate reflux symptoms.

Acid reflux occurs when stomach contents, including acid, flow backward into the esophagus, producing a burning sensation commonly called heartburn. A valve at the base of the esophagus, the lower esophageal sphincter (LES), normally limits this backward flow. Physicians say that increasing pressure in the stomach — for example, from swallowing large volumes of liquid with a meal — can promote transient relaxations of the LES or overcome the valve, increasing the likelihood of reflux.

Pelletier singled out two common patterns she said can be problematic: taking large, rapid swallows of water during meals and consuming very cold water on an empty stomach. Both, she said, are associated with symptoms such as bloating, regurgitation and throat clearing. Clinical explanations for such reports include gastric distension from large liquid volumes and individual sensitivity to temperature; some people report that extreme temperatures can provoke esophageal discomfort.

Dietitians and gastroenterologists who treat reflux often recommend lifestyle adjustments alongside any medical treatment. Common guidance includes moderating portion sizes, avoiding late large meals, steering clear of known dietary triggers, and spacing fluids so that large volumes are not ingested at once with a meal. Many clinicians also advise people with persistent or severe symptoms to seek medical evaluation to rule out complications such as esophagitis or other underlying conditions.

Experts emphasize that hydration remains important for overall health, and that replacing sugary sodas with water is generally beneficial. However, Pelletier and other clinicians say that subtle aspects of drinking behavior — when, how much and the temperature of the water — may influence symptom control for some people with reflux. Individuals who notice a clear pattern between their drinking habits and reflux symptoms are advised to discuss adjustments with a healthcare professional to tailor changes to their specific needs.

If symptoms are frequent, disruptive or accompanied by difficulty swallowing, unintentional weight loss, or bleeding, medical assessment is recommended. Clinicians can evaluate symptom severity, recommend medical or lifestyle treatments, and investigate for complications if needed.