Heartburn/GERD Symptoms

Heartburn and regurgitation are classic symptoms of GERD. The back flow of acid stimulates the nerve fibers in the esophagus, and this commonly results in heartburn. The episodes of heartburn can last up to a couple of hours. It is usually described as burning pain behind the breast bone. The discomfort may start in the epigastric area or the upper abdomen and may spread into the neck. In some cases, the pain may be sharp or pressure-like, rather than burning. It may even be mistaken as a heart attack. Some patients report that the pain may extend to the back. Acid reflux is more common after meals, hence many people who have GERD notice that their heartburn is worse after eating.

Heartburn is also more common when on supine position or flat on the back. Without the effects of gravity, the stomach contents may easily move backwards into the esophagus and return to the stomach at a slower rate. Many people with GERD are awakened from sleep by the discomfort caused by heartburn

Acid regurgitation is the unpleasant return of sour and bitter stomach contents in the pharynx. At the upper end of the esophagus is a valve known as upper esophageal sphincter (UES) which prevents esophageal contents from backing up into the throat. When small amounts of refluxed substance get through the UES and enter the throat, there may be an acid taste in the mouth. Frequent regurgitation can lead to acid-induced erosions of the teeth.

Painful or difficult swallowingis also a common symptom of GERD. Frequent regurgitation of stomach contents can irritate the lining of the esophagus, this can result in inflammation or ulcers. Pain occurs when swallowed food passes the inflamed areas of the esophagus. When the irritated areas heal, its damaged cells are replaced, but the scarring may cause narrowing of the esophagus. This can result in difficulty swallowing or feeling that food is stuck in the throat.

Other signs and symptoms include:

• dry cough
• hoarseness or sore throat
• a feeling of choking
• bad breath

It is very important to contact your doctor if symptoms occur frequently, and if they interfere with your daily activities. Some symptoms of GERD also occur in other health problems, the doctor's evaluation will help in determining whether the signs and symptoms are caused by GERD or other conditions.

1. Granderath, F., Kamolz, T., Pointner, R. Gastroesophageal reflux disease: principles of disease, diagnosis, and treatment. 2006. Springer
2. Burns, D., Shah, N. One hundred questions & answers about gatroesophageal reflux disease (GERD). 2007. Jones & Bartlett Publishers.