Water Brash

What is water brash?

Water brash is a symptom of gastroesophageal reflux disease (GERD). With GERD, stomach acid rises from your stomach and flows into your esophagus and mouth. If you have water brash, your salivary glands work overtime producing excessive saliva (spit) while the acid rises. While there isn’t a set amount of spit, some people with water brash salivate up to 10 milliliters (2 teaspoons) per minute.

When the saliva and stomach acid mix in your mouth, it may feel like there’s liquid stuck in the back of your throat. You may notice a sour or acidic taste in your mouth.

Other names for water brash include acid brash, pyrosis idiopathica and hypersalivation.

What other symptoms happen alongside water brash?

Water brash is one potential GERD symptom. You may experience water brash alongside other GERD symptoms, including:

• Heartburn (a burning feeling in your chest from the stomach acid).
• Regurgitation (when a mixture of stomach acid and partially digested food moves up into your throat).
• Difficulty swallowing (it may feel like food is stuck in your throat).
• Noncardiac chest pain (pain in the part of your esophagus that’s near your heart).
• Nausea.
• Loss of appetite.

Some people mistake regurgitation for water brash, but they’re two different things. With regurgitation, some of your stomach contents come back up in your throat. Water brash involves excess saliva production. Regurgitation is a more common GERD symptom than water brash.

What causes water brash?

The changes in your body that cause GERD also lead to symptoms like water brash.

GERD symptoms occur when stomach acid flows upward into your esophagus. For this to happen, the acid has to seep past a valve at the bottom of your esophagus called the lower esophageal sphincter (LES). When things are working right, the valve opens to allow food to pass into your stomach and seals shut to prevent acid from rising.

But, if your LES is weak, injured or too relaxed, stomach acid can slip past it. When the highly acidic fluid comes into contact with the sensitive tissue in your throat, the results can feel like burning (heartburn). The process can trigger unpleasant responses like regurgitation or water brash.

Experts continue to research what causes the overproduction of saliva in people who experience water brash. The acid in your esophagus may trigger your salivary glands to produce more spit. This is called the esophago-salivary reflex. Since saliva is mostly water, it may be your body’s attempt to neutralize (dilute) the acid in your mouth and throat.

But not everyone with GERD experiences water brash.

Research is ongoing to determine the processes that cause some people with GERD to produce excess spit while others don’t.

How is water brash treated?

Treatments for water brash are the same as with GERD. Typically, you can treat water brash at home by adjusting your lifestyle or taking medicines to treat GERD.

Lifestyle adjustments you can make include:

• Quitting smoking.
• Maintaining a weight that’s healthy for you.
• Avoiding (or reducing) consumption of beverages that contain alcohol.
• Eating several small meals a day instead of three big ones.
• Eating slowly (to give your digestive system plenty of time to break down food).
• Taking a brief walk after you eat.
• Avoiding eating too soon before bedtime. (Aim for a light dinner at least three hours before bedtime.)

Your healthcare provider may recommend medications that neutralize or reduce stomach acid production. Medications include:

• Antacids (Tums® and Rolaids®): Antacids provide symptom relief fast, within 30 minutes. They’re available over the counter (OTC).
• Histamine-2 receptor antagonists (H2 blockers): H2 blockers take about an hour to relieve GERD symptoms, but the effects last for up to 10 hours. They’re available by prescription.
• Proton pump inhibitors (PPIs): PPIs provide long-term relief for GERD symptoms. They take longer to start working (24 hours to four days), but their effects last longer than either antacids or H2 blockers. They’re available by prescription.

Are there foods I should avoid to prevent water brash?

There aren’t specific foods or drinks that cause water brash or GERD. Still, foods that may cause your LES to relax or that take longer to digest increase the likelihood you’ll experience symptoms.

If you’re experiencing discomfort from GERD symptoms, you may want to avoid:

• Fried, fatty or spicy foods.
• Foods high in caffeine, like chocolate or coffee.
• Carbonated drinks, like soda.
• Citrus fruits.
• Onions.
• Garlic.
• Mint.

But everyone’s experience is different. Keep track of the foods that cause you to experience water brash, and try to avoid them.

How do I stop water brash?

If you’re experiencing symptoms and need relief fast:

• Stand up: Standing upright allows gravity to help pull the acid back down into your stomach.
• Loosen your belt or change into looser pants: Make sure there’s no pressure on your stomach that may encourage stomach acid to flow upward.
• Take an antacid: Antacids provide the fastest relief for GERD symptoms.

Can I prevent water brash?

The same strategies that help manage GERD can reduce your risk of experiencing water brash. Ask your healthcare provider if you need prescription medicines to reduce GERD-related symptoms.

When should water brash be treated by a doctor or healthcare provider?

If you’re experiencing symptoms of acid reflux, including water brash, for two or more weeks, it’s time to reach out to your provider. Water brash alone isn’t dangerous, but the condition that causes it (GERD) can do long-term damage to your esophagus without treatment.

A note from Cleveland Clinic

Water brash, heartburn and regurgitation are all symptoms of GERD, the chronic form of acid reflux. As unpleasant as these symptoms feel, they’re usually manageable with lifestyle changes and medications. Most people find relief by taking medications and changing their eating habits. Your healthcare provider can advise you on the best treatment plan.