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What is water brash?

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People with gastroesophageal reflux disease may experience a symptom called water brash. Water brash occurs when a person produces an excessive amount of saliva that mixes with stomach acids that have risen to the throat. A person experiencing water brash can get a bad taste in their mouth and feel heartburn. Doctors sometimes refer to water brash as pyrosis idiopathica, acid brash, or hypersalivation. Water brash is different than regurgitation — in which a mixture of stomach acids and, sometimes, undigested food comes up into the esophagus (food pipe) — due to the excessive salivation that it involves. Keep reading to learn more about water brash, including the associated symptoms, possible causes, and treatment options.

What is water brash?

Water brash is a typical symptom of gastroesophageal reflux disease (GERD). GERD is a common condition of the digestive system. According to experts, the prevalence of GERD is increasing in many developing countries. GERD symptoms, including water brash, may have a significant effect on work productivity and many other aspects of day-to-day life.


In people with water brash, the salivary glands tend to produce too much saliva. The excess saliva can combine with stomach acids and cause heartburn. People describe heartburn as a burning sensation behind their chest bone. Sometimes, a person may also get a sour taste in their mouth. Regurgitation is a more common symptom of GERD than water brash.


GERD symptoms occur because the normal mechanisms that prevent stomach acid from rising into the esophagus fail to function correctly. In many cases, this is because the lower esophageal sphincter is not working properly.

Another mechanism that can fail is the function of the phrenico-esophageal ligament. This ligament, which attaches the esophagus to the diaphragm, affects the movements of these structures during swallowing. If the ligament weakens, people can experience symptoms of GERD, including water brash.

ResearchTrusted Source suggests that people with GERD may produce excess saliva due to the presence of acid in the esophagus, which activates the esophagosalivary reflex.

To test this theory, researchers administered either saline solution or an acid solution into the esophagus of 15 volunteers. They noticed an increase in the production of saliva in response to the acid.

Saliva is less acidic than the contents of the stomach. Therefore, the increased production of saliva that occurs with water brash may help reduce the acidity of the stomach contents.


People can try to manage their GERD symptoms, including water brash, with over-the-counter (OTC) medications. A local pharmacist or another healthcare professional can offer them advice on the best treatment. If the symptoms are severe or last longer than 2 weeks, a person should consult a doctor. Some people may need a referral to a gastroenterologist.

The treatment for GERD will often help provide relief from water brash. The goals when treating GERD include:

  • relieving and preventing symptoms
  • improving quality of life
  • decreasing esophagitis, which is the inflammation of the esophagus
  • preventing or treating any complications of GERD

Depending on the frequency and severity of a person’s symptoms, doctors may recommend one or a combination of the following medications:

  • antacids
  • proton pump inhibitors
  • histamine-2 receptor antagonists

Making lifestyle changes can often help relieve symptoms of GERD. These may include:

  • avoiding large meals close to bedtime
  • quitting smoking, if applicable
  • achieving and maintaining a moderate body weight
  • avoiding foods and drinks that trigger symptoms, such as spicy foods, greasy foods, and alcohol

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