Acid Reflux Symptoms

GERD is the most common condition to affect the esophagus. The disease spectrum ranges from patients with heartburn and other reflux symptoms without any evidence of injury to esophageal mucosa (endoscopy negative reflux disease) to patients with deep ulcer, stricture or Barrett’s epithelium. Everyone has some degree of gastroesophageal reflux; it becomes pathological only when associated with troublesome symptoms or complications.

Signs and symptoms

Many patients present with heartburn and acid regurgitation that occur after certain food or following certain postural maneuvers like bending forward or lying flat. The following are the various signs and symptoms of acid reflux.

Heartburn

The most common manifestation of GERD is heartburn. Patients report a burning feeling, rising from the stomach or lower chest and radiating toward the neck, throat, and occasionally the back. It occurs particularly after large meals or after ingesting spicy foods, citrus products, fats, chocolates, and alcohol. The supine position and bending over may worsen heartburn. Nighttime heartburn may cause sleeping difficulties and impair next-day function. GERD is usually diagnosed symptomatically by the occurrence of heartburn 2 or more days a week, although less frequent symptoms do not preclude the disease. Although an aid to diagnosis, the frequency and severity of heartburn do not predict the degree of esophageal damage.

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Regurgitation

Regurgitation is the effortless bringing out of gastric contents through the esophagus into the oral cavity without nausea, retching, or abdominal contractions. Frequently it occurs with a belch, bending, or other maneuver that increases intraabdominal pressure.

Water Brash

Water brash refers to a foaming at the mouth caused by hyperproduction of salivary juice. In contrast to regurgitation, water brash is not bitter; it has a salty or a bland water-like taste.

Dysphagia (Swallowing difficulty)

Dysphagia is seen in up to 40% of patients with long-standing GERD and may herald the presence of an esophageal stricture. Stricture indicates narrowing and it could be a benign stricture or sometimes cancer.

Odynophagia

Odynophagia is the symptom of painful swallowing. This symptom is usually described as a sharp or lancinating pain located behind the chest bone.

Patients with GERD sometimes suffer from symptoms which arise from outside the esophagus. These include the following:

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Chest Pain

GER-related chest pain may mimic angina pectoris, having a squeezing or burning quality. It frequently is worse after meals, can awaken the patient from sleep, and may worsen during emotional stress.

Asthma and Other Pulmonary Diseases

Symptomatic GERD is an important condition associated with asthma, being associated with greater asthma severity. GERD should be considered in asthmatics who present in adulthood. Up to 30% of patients with GERD-related asthma have no esophageal complaints. Other pulmonary diseases associated with GERD include aspiration pneumonia, interstitial pulmonary fibrosis, chronic bronchitis, bronchiectasis, and possibly cystic fibrosis, neonatal bronchopulmonary dysplasia and sudden infant death syndrome.

Ear, Nose, and Throat Diseases

GERD may be associated with a variety of laryngeal symptoms and signs, of which "reflux laryngitis" is the most common. These patients present with hoarseness, stickiness in the throat, frequent throat clearing, recurrent sore throat, and prolonged voice warm-up.

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