Gastroesophageal reflux disease: symptoms

A sour taste in the mouth after coffee or heartburn after a heavy dinner is familiar to almost everyone. But if this recurs regularly, it may no longer be a one-off discomfort but gastroesophageal reflux disease. Let's figure out which symptoms are characteristic of it and when it's time to see a doctor.

What gastroesophageal reflux disease is

First, what it is not: GERD is not "just heartburn" and not a death sentence. It is a chronic relapsing disease in which the contents of the stomach regularly flow back into the esophagus. The cause is a malfunction of the muscle in the lower part of the esophagus, which normally closes the way for stomach contents upward. If it relaxes at the wrong moment or is weakened, acid irritates the esophageal mucosa.

Frequency matters: if symptoms occur twice a week or more often, or already damage the esophageal mucosa, it is called GERD. A one-off reflux after a large dinner is not yet a disease.

Main symptoms of acid reflux

The main sign is heartburn, a burning in the middle of the chest. Besides heartburn, a sour or unpleasant taste in the mouth due to acid reflux is typical. Symptoms usually worsen after eating, in a lying position, and when bending the torso forward. This may be accompanied by:

• cough or hiccups that keep coming back;
• hoarseness of the voice;
• bad breath;
• bloating and nausea.

In some people, GERD occurs without heartburn — this does not cancel the diagnosis.

Extraesophageal manifestations: cough, hoarseness, chest pain

Reflux can mask itself. Pulmonary symptoms include cough and shortness of breath, more often occurring in a lying position. Otorhinolaryngological manifestations include hoarseness of the voice, dryness in the throat, and a white coating on the tongue. There may also be retrosternal pain radiating to the interscapular region, neck, lower jaw, or left half of the chest. Such pain requires attention: it must be distinguished from cardiac pain.

How GERD differs from one-off heartburn

One-off reflux happens to many people and often without an obvious cause. GERD is regularity plus consequences: symptoms twice a week or more often, or damage to the esophageal mucosa. In 45–80% of patients with GERD, examination reveals esophagitis — inflammation of the esophagus.

Complications of reflux disease

Without monitoring, GERD can lead to inflammation of the esophagus, scarring, and changes in the tissue of its mucosa — Barrett's esophagus. Asthma may worsen, and chronic cough or hoarseness may appear. Among patients with esophagitis, the prevalence of Barrett's esophagus ranges from 5 to 30%.

How GERD is diagnosed and when to see a doctor

The doctor asks about symptoms and medical history. If necessary, examinations are prescribed: endoscopy of the upper gastrointestinal tract with a camera, biopsy, X-ray, esophageal pH-metry (measures how often and how long acid refluxes), esophageal manometry, and transnasal esophagoscopy. It's time to see a doctor if lifestyle changes and over-the-counter remedies do not help, heartburn occurs almost daily, or other symptoms appear — food gets stuck in the throat, frequent vomiting, unexplained weight loss.

On its own it is not a reason to call an ambulance; 103/112 — if chest pain is accompanied by shortness of breath or radiates to the jaw or arm: these may be signs of a heart problem.

This material is for reference: it helps you recognize your symptoms, but does not replace a doctor's consultation — the final diagnosis is made by a specialist after examination.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer