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Symptoms and Signs of Acid Reflux (GERD)

Doctor's Notes on Acid Reflux (GERD)

Acid reflux, or gastroesophageal reflux disease (GERD), is a condition in which the acid contents of the stomach back up into the esophagus (swallowing tube or food tube). This can cause damage and irritation of the lining of the esophagus. The cause of GERD is believed to be complex and is not fully understood. Conditions such as lower esophageal sphincter abnormalities, abnormal contractions of the esophagus, hiatal hernias, and slow or prolonged emptying of the stomach are believed to play a role.

The main symptoms associated with GERD are heartburn, nausea, and regurgitation. Heartburn is felt as a burning pain in the middle chest. It can sometimes feel like pressure and may mimic the pain of heart disease. Regurgitation is the presence of refluxed liquid in the mouth.

Medical Author:
Medically Reviewed on 3/11/2019

Acid Reflux (GERD) Symptoms

Persistent heartburn is the most common symptom of GERD.

  • Heartburn is a burning pain in the center of the chest, behind the breastbone. It often starts in the upper abdomen and spreads up into the neck or throat.
  • The pain can last as long as 2 hours.
  • Heartburn is usually worse after eating.
  • Lying down or bending over can bring on heartburn or make it worse.
  • The pain usually does not start or get worse with physical activity.
  • Heartburn is sometimes referred to as acid indigestion.
  • Not everyone with GERD has heartburn.

Other symptoms of GERD include:

  • Regurgitation of bitter acid up into the throat while sleeping or bending over
  • Bitter taste in the mouth
  • Persistent dry cough
  • Hoarseness (especially in the morning)
  • Feeling of tightness in the throat, as if a piece of food is stuck there
  • Trouble swallowing
  • Sore throat
  • Wheezing
  • Nausea
  • Post-meal pain in the abdomen

The most common symptoms in children and infants are repeated vomiting, coughing, and other respiratory problems.

Acid Reflux (GERD) Causes

There are many factors that influence the symptoms of GERD. The following are contributing factors that weaken or relax the lower esophageal sphincter, making gastric reflux worse:

  • Lifestyle: Use of alcohol or cigarettes, obesity, poor posture (slouching)
  • Medications: Calcium channel blockers, theophylline (Tedral, Hydrophed, Marax, Bronchial, Quibron), nitrates, antihistamines
  • Diet: Fatty and fried foods, chocolate, garlic and onions, drinks with caffeine, acidic foods such as citrus fruits and tomatoes, spicy foods, mint flavorings
  • Eating habits: Eating large meals, eating quickly or soon before bedtime
  • Other medical conditions: Hiatal hernia, pregnancy, diabetes, rapid weight gain

Hiatal hernia is a condition where the upper part of the stomach protrudes through the opening in the diaphragm where the esophagus passes through to its connection with the stomach. In this case, the upper part of the stomach is up above the diaphragm (the strong muscle that separates the organs of the chest from those of the abdomen).

  • Normally, the diaphragm acts as an additional barrier, helping the lower esophageal sphincter keep acid from backing up into the esophagus.
  • The cause of hiatal hernias is not clear, but it is possible that it can occur because of persistent coughing, vomiting, straining, or sudden physical exertion. Obesity and pregnancy can make the condition worse.
  • A hiatal hernia makes it easier for the acid to back up.
  • Hiatal hernia is very common in people older than 50 years of age and often is not associated with GERD.
  • Hiatal hernia usually requires no treatment. In rare cases when the hernia is large or becomes twisted, surgery may be required.

Heartburn (Acid Reflux, GERD) Causes and Remedies Slideshow

Heartburn (Acid Reflux, GERD) Causes and Remedies Slideshow

Heartburn is a burning sensation in the middle of the chest behind the breastbone and in the middle of the abdomen. It occurs when acid and other contents of the stomach travel up the esophagus and irritate the tissues. A faulty stomach valve allows acid and stomach contents to escape and cause the burning sensation. Approximately 60 million Americans suffer from the condition at least once a month. Approximately 15 million Americans suffer from it daily. Eating spicy foods and overeating are common triggers of the symptom. Indigestion is another name for heartburn.

REFERENCE:

Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.

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