Acid reflux occurs when the acid content of the stomach backs up into the esophagus.
This fact alone is not enough to determine heartburn and other related symptoms.
However, in some cases, the affected person starts to experience some troubles and these can significantly hinder the quality of life.
That’s why is very important to better understand and recognize symptoms of acid reflux, in order for you to act promptly and properly.
The first important step to take now is to present an overview of such symptoms, then we’ll go deeper to describe the most common.
And the least common as well, because there still are some controversies about how the reflux can appear.
This is also important because if not correctly recognized through real symptoms, the disease progresses.
And further complications may the whole thing a lot worse.
This is what we want to avoid.
Symptoms Of Acid Reflux: Learning The Difference
Generally speaking, we should say that the most common symptom is heartburn.
Yes, it may sound quite weird, but it’s true.
In fact, the burning sensation the affected people refer to in almost all cases, it’s exactly the heartburn.
In the short video below (59 sec.) you can find a proper explanation.
Acid reflux is the condition, heartburn (also called pyrosis) is the resulting effect.
This is a thing to remember.
Acid reflux is the disease, heartburn and other symptoms are the direct consequence, and they are due to the action of acid stomach content when it’s found inside the esophagus.
According to the position of the body, some relevant habits, activities and eating habits as well, symptoms may be weak or strong.
In some cases, there are no symptoms at all.
However, in many cases, they are reported frequently, and their number is higher than expected.
Symptoms Of Heartburn: An Overview
Given that acid reflux and heartburn, although considered as the same thing, are in reality two different aspects of the same condition, we can move forward.
There are at least three equally important criteria to define if heartburn deserves more attention.
- the occurrence of two or more episodes over a week
- the persistent use of some medications (especially antacid drugs) to get rid of this condition
- significant impairment of the quality of life
According to periodically updated studies, reflux is one of the most common diseases in the world.
Moreover, the trend is increasing.
That’s why there are more and more people all across the planet who currently experience the criteria listed above.
In this other study, we can read that the prevalence of reflux disease may range from 8% up to 33% of the world population.
In the image below (source Reflux Centar Beograd, Serbia) we can learn the mean prevalence of the disease.
This means that people have to better understand symptoms and how to treat the condition, in order for reducing their risk to develop complications and to spend a lot of money with almost useless chemical drugs.
Everything starts with symptoms. If you don’t recognize them, you won’t be able to take action properly.
Not an easy task, in some cases, because not all people have the same symptoms, even with the same starting conditions.
In addition, symptoms may vary a lot. They can range from mild to severe and, generally, they are more frequent and stronger after a fatty or spicy (or in general heavy) meal, or when the person is lying down (or bending over).
Symptoms may occur at any moment, even if nighttime is often reported as the moment of the day with the more difficult. This is due to the position of the body.
What does acid reflux feel like?
To make things clearer, you can find a list of the most common symptoms below, while later on, we’ll present some additional and often crucial aspects of heartburn you must consider.
The most common symptoms are the following:
Persistent heartburn; yes, it’s true. Heartburn is the most common symptom of acid reflux. The frequency (more than two times per week) and the intensity (with impairment of the quality of life) are the two things to consider.
Regurgitation occurs when (but not only) the person is sleeping or bending over. This regurgitation involves bitter acid up into the throat and once appeared for the first time, it’s quite specific and easy to recognize (you can take it as a reference for heartburn frequency measure, especially when associated to the burning sensation).
It’s important to point out that regurgitation and reflux with heartburn are not the same. In fact, heartburn and regurgitation have a significantly different impact on the quality of life of the people who suffer from gastroesophageal reflux. In the table below we can find some characteristics of two samples of people, one with heartburn, compared to others with regurgitation.
A dry cough is another interesting and frequent symptom. In particular, we can read here that dry cough has close relationships with some typical features of heartburn, such as the irritation in the throat and the sensation in the chest. Below a table that shows this relationship.
Hoarseness can be present in reflux sufferers. This symptom is related to some internal diseases, such as the LPR (Laringo Pharyngeal Reflux). As we can see from the table below, hoarseness can be predominant at night and it’s expected to be slight. The presence of reflux or not is the requisite for taking medications (the table tells PPI, while we don’t recommend them).
The feeling of tightness in the throat is another common symptom. To give you a better idea, it’s like having a piece of food stuck in the throat: it doesn’t go down, and it doesn’t come back. Weird sensation, because it can potentially impair the swallowing function.
That’s why troubles in swallowing are another frequent symptom to include in the list. It’s related to what we’ve seen above.
Although no specific relationship has been proven between this symptom and acid reflux, wheezing is another effect to consider. In fact, it has been noted that even if an occasional coughing episode can lead to reflux, it’s rather the reflux episode in the vast majority of cases that leads to cough and wheezes.
Nausea is very common in reflux sufferers. We present here a more detailed analysis of that. For what concerns nausea as a common symptom of the reflux disease, we can say that it may be present during pregnancy or not. In the case of pregnancy, it leads to increased severity of vomiting. That’s why this symptom, especially during pregnancy, has to be controlled very carefully. In the image below a report of severity of nausea and vomiting during pregnancy.
After a meal, people may experience abdominal pain. This symptom can be present in adults and children. However, when concerning children, it has to be investigated carefully (read the last paragraph).
The relationship between weight and heartburn is interesting. In fact, even if weight loss for no known reason is a possible symptom of acid reflux, it has been observed that the BMI (Body Mass Index) reduction in people with reflux does also reduce symptoms. In addition, after the weight reduction, the same people respond better to heartburn treatments, including medications. The image below is a calculator for your BMI you can use right now (source BMI Calculator Ireland).
Bad breath is also typical in the case of acid reflux.
To be more complete, halitosis has a demonstrated close relationship with reflux, while the same has not been found with other equally important digestive disorders, such as Helicobacter pylori infection, peptic ulcer disease and functional dyspepsia). The graphic below shows the close relationship between bad breath (in this case, severe halitosis) and heartburn.
The presence of extra-saliva (produced all of a sudden) is reported as one of the least known, but still valid symptoms that can hide a reflux disease. This is due to the “water brash“, which is a reflex similar to vomit.
Bloating is another possible symptom. Reflux belongs to the category of digestive disorders, then bloating can be present on a case by case basis. Overeating is often the main cause and this is common to both boating and reflux. Fatty meals and heavy meals (no matter the ingredients) are also a causing factor.
In addition to the above common (and less known) symptoms, we have to remember that heartburn may occur as a manifestation of dyspepsia. In such cases, the concomitant presence of other symptoms like excessive burping and/or vomiting, an uncomfortable sense of “fullness”, along with nausea, upset stomach and bloating, should help the diagnosis.
Below there is a summary table with the likely most common symptoms to remember (source Dr. Jose M Remes-Troche via Research Gate).
Some emergency symptoms to know
Heartburn can be very serious, and when things are worse than normal there are some symptoms to consider.
You should take them like alarm signals that deserve the greatest attention.
Among them, certainly, there are the following.
First of all, observation and experience are essential. This means that when a heartburn episode looks worse than normal, it deserves the greatest attention.
A crushing sensation (severe pain) in the chest is another relevant symptom.
This also can happen to the upper back, and in some cases, also in the lower-back zone.
Nausea, as we’ve seen in the previous paragraph, is not only important for pregnant women. Everyone has to pay attention to it.
The same for vertigo/dizziness, sweating and when a pain sensation moves involving the left arm, shoulder, back, neck and even jaw, in some cases.
Another important thing to consider (and to check periodically) is the aspect of feces.
In fact, the presence of dark-maroon or black-tar stools is a possible sign of stomach bleeding (like in the case of peptic ulcer).
A coffee ground – like vomited material is another important sign to be investigated.
Heartburn: a symptom of heart attack?
The answer to the question is: no, heartburn is not a sign of heart attack, even though it may look like that.
Acid reflux is one of the most frequent causes of chest pain, but the worst thing is that it can be confused with a heart attack.
There are some facts to consider to avoid this confusion.
In the video below you can find good information on that.
A pain can improve after a quick antacid or even a burp, and in all these cases there’s not a heart attack, but more likely heartburn.
In these cases, the person likely feels a sour taste in the mouth as well.
Generally, in the presence of a heart attack, chest pain goes along with shortness of breath and squeezing feeling.
These concomitant situations deserve immediate medical (emergency) care.
Even if symptoms might seem similar, there’s a solid difference between these two conditions.
And they’re not related to each other.
Just a quick addition: it has been observed that many people with coronary disease also present reflux and refractory heartburn (meaning that it’s harder to treat).
In these cases, the proper diagnosis is crucial. Some heart medications can aggravate heartburn.
It’s an important case to remember because even if heart and reflux can be present together, they still are a totally different thing.
Burning sensation in throat and chest
This is likely the most common and reported symptom.
This burning sensation can also be located in the upper abdominal tract.
In some cases, it’s possible to feel a sour taste in the throat or even in the mouth. This is due to the reflux of acid content up to the highest tract of the digestive system.
That acid content is the causing factor of both the sour taste and the burning sensation.
This happens especially when the body is lying down or, during the night, when sleeping on the right side (sleeping on the left side is, on the contrary, a protective measure).
Heartburn also occurs frequently after eating, that’s why diet is so important to control symptoms.
A moderate physical activity does not trigger the heartburn, unlike extreme physical training.
The burning sensation and the sour taste help other symptoms to appear more clearly, like nausea and an overall sense of illness.
Heartburn in the morning
Despite nighttime is considered the hardest moment for reflux sufferers (especially when they are eating fats or spices and do not sleep on the left side), morning is important as well.
There are some people who report the morning as the moment with more symptoms.
The fact is: stomach is in a fasting mode all over the night. This means that it may become full of acid in the morning.
By doing so, some people with reflux may experience symptoms in this particular moment of the day, because that acid content goes up.
The lower esophageal sphincter is weak (lower pressure) and the acid can move.
This may not occur in all cases, however, if it happens, there’s a need to act on everything that can change this situation.
Heartburn and gas
Burping is one of the most common signs of heartburn.
Gas and reflux are closely related. To be more precise, the presence of gas relates to a variety of digestive disorders.
There’s a specific condition, called “acid vapor”, can be perceived in the case of heartburn and regurgitation (even without “real” heartburn).
This condition is due to the pure gas reflux that occurs when pH is low (acidic).
In the image below, we can find that belching is also related to esophageal hypomotility.
As a consequence, burping can be present even without any reflux of stomach acid content.
Generally speaking, the presence of burping as a symptom refers to the lower pressure of the esophageal sphincter, which lets the acid vapors pass as much as the contents of the stomach.
Burping is a condition that deserves more and specific attention especially because of its high frequency among the people who suffer from acid reflux.
Signs Of Acid Reflux
Unlike symptoms, signs are objective manifestations that occur in people with heartburn and acid reflux.
They are important because often symptoms are subjective. This means that each individual can report more or less serious symptoms, while signs are a fact, and everyone can notice them.
Among them, we remember the following.
Dental erosion (in general) is an important sign and deserves maximum attention. It’s not an “exclusive” of acid reflux and can relate to other conditions.
Not to mention the importance of certain eating habits and oral hygiene.
To focus our attention on heartburn and reflux, it has been observed that this condition can lead to dental erosion.
There are some areas of the planet where more than 60% of the people with reflux also present dental erosion.
In some other cases, it has been noted that dental erosion has a good correlation with the so-called “silent reflux”, aka LPR (Laringo Pharyngeal Reflux).
Whatever the case, this sign should be recognized as soon as possible, because of its important effects on oral health.
Hiccups are frequent in the case of acid reflux. Interesting fact, hiccups are often related to reflux but even surgical therapy is not always able to solve the issue.
That’s why this sign has to be considered with extreme attention and should never be underestimated.
Belching is a frequent sign even though it’s not specific to heartburn.
There are some other diseases that make the diagnosis quite challenging, especially when other signs and symptoms are not so well defined.
Belching cannot be used as a discriminatory sign between dyspepsia and GERD, even if belching and heartburn in GERD patients are more likely correlated with episodes of pathological reflux.
Even though we considered dry cough and wheezing among symptoms, they may also be considered signs, because of their detectable effects.
The same for weight loss and emergency signs like the aspect of feces and vomit we’ve discusses before.
GERD and urinary symptoms: a strange couple
This topic pops up from time to time and still poses some questions.
To make things clear, we can say what follows.
Of course, things are totally different if you think about urine reflux and kidney problems. but we are talking about GERD, which means two distinct systems (urinary and digestive).
However, there are some connections between the urinary and digestive systems.
This is valid for several urinary infections, caused by bacteria normally found in the digestive system (such as the E. Coli).
Even though it’s quite “promotional” for her therapeutic schemes, you can find a special case study reported by Brie Wieselman (we’re not affiliated to her in any way).
She works in the field of gut health, but what matters most is that in some cases two different conditions (such as reflux and urinary troubles) may share the same root cause.
It’s not about a single cause, but rather a complex of factors.
A urinary tract infection, treated with antibiotics, at the beginning. Then, additional antibiotics later on because of a long trip. As a consequence, acid reflux symptoms started.
A quite particular analysis of the situation, which however tells us that our body is complex, and the best thing we can do is to listen to it, then act accordingly.
This is an important topic.
Chronic heartburn is also called “uncontrollable” heartburn.
This means that heartburn symptoms last for more time. It basically becomes a chronic disease, with a more serious list of adverse effects and possible complications.
We are talking about a very long time. For instance 3 years of heartburn symptoms with no improvement, even with medications.
The table below gives a better idea of the potential progress of this disease when chronic heartburn is not well treated.
There is an interesting piece of content to read on the matter: “When heartburn lingers too long“, by Dr. Michael Brown, MD from Rush Medical Center in Chicago (IL).
You can find useful information about what should be done when dealing with heartburn symptoms that last for much more time than usual.
For example, how to diagnose it and what to do next, including surgery.
You have not to be scared, but, because of the generally long life of heartburn symptoms, it’s necessary to consider all possible options.
This because, in the majority of the people, heartburn symptoms don’t have a long duration.
How long does heartburn last?
The pain can last for 2 hours, but it depends on the case.
The duration of heartburn is one of the most considered parameters when it comes to treating the disease.
As we can read from this study (a bit old but still interesting), therapy is considered successful when it enables to control symptoms for a longer time.
This means that the first stage of successful therapy is not to make the heartburn disappear suddenly.
On the contrary, the period with limited symptoms is longer, and the duration of heartburn episodes is shorter than before.
Infant GERD Symptoms
When it comes to infants, generally there’s nothing to worry about.
In fact, gastroesophageal reflux is quite common, at least up to 12-18 months of age.
To be more precise, only 5% of infants (approximately) are continuing to experience reflux at 1 year of age.
This is a frequently experienced physiologic condition occurring several times a day, mostly postprandial and causes no symptoms. These children are called “happy spitters”.
In the short video below you can find some useful information about how to know if a baby has reflux.
According to studies, about 70-85% of infants have regurgitation within the first 2 months of life, and this resolves without intervention in 95% of infants by 1 year of age.
The “real” GERD disease occurs when reflux of the gastric contents causes symptoms able to affect the quality of life or pathologic complications, such as:
- Weight loss or inadequate weight gain
- Crying and fussiness during and after feeding
- Emesis and/or hematemesis
- Bad breath, gagging or choking at the end of a feeding
- Sleeping disturbance and frequent night waking
- Abdominal pain
- Dental erosion
- Dystonic neck posturing (Sandifer syndrome)
- Respiratory symptoms (aspiration, recurrent pneumonia, chronic stridor, wheezing)
In some cases, life-threatening events are also possible.
The above-listed symptoms are often non-specific and can either mimic or be caused by other infancy-related conditions.
Not to mention that in about 42-58% of infants a cow milk’s protein allergy overlaps with GERD, and these two conditions coexist.
Symptoms of acid reflux in children
In older children, things are slightly different.
To make things clear, we report a table below. It shows GERD-related symptoms grouped by age.
As we can see, the differences are also due to the fact that children cannot express their feelings up to 3 years of age (generally).
Another important symptom to remember is the recurrent abdominal pain (RAP) in children.
It refers to the frequency and duration of heartburn episodes in children.
In particular, the threshold to consider is the following: 3 months in the preceding period and, over this 3 months period of time, the occurrence of at least 3 serious episodes of pain that are severe enough to affect the daily activities of the affected patients.
Abdominal pain is closely related to acid reflux in children, and this has been proved because successful treatments for heartburn also fixed the abdominal pain.
After reading so much content about symptoms of acid reflux, it’s time to make a recap.
At the end of this analysis, there 27 essential things to remember, because they enable a better knowledge of the disease.
This is extremely important because it helps to minimize the progress of the disease.
and, last but not least, to avoid chemical drugs and harmful medications that can make things even worse.
So, let’s sum up the 27 essentials to remember.
You should take note of them, and always keep them with you, just like a helpful checklist, for an easy consultation in case of need or doubts.
What To Do Next
Now that you’re read what are the most common and the least know symptoms of acid reflux, it’s time to take action.
Because all the above-listed symptoms can be addressed very well with the proper solution.
We also suggest learning more about why reflux and heartburn affect so many people all across the world.
This is extremely important for starting your battle against the disease.
To make things more complete, you can check below this series of natural reliefs that work very well.
You’re going to find some useful tips and something really little known about remedies for heartburn and acid reflux.
For the moment, thank you so much for your visit!
The Proven Holistic 5-Step System
One of the best strategies. Its strength point is the holistic approach, which means that you're going to care about all aspects that may affect your organism, in 5 steps. Also known as "Heartburn No More".
The Three Everyday Ingredients
This strategy works on underestimated aspects, such as food combinations that are much more important than avoiding certain types of foods. Also known as "The Acid Reflux Strategy".
The Double Protocol For Reflux
It targets two conditions at the same time: acid reflux and infection by H. pylori. Quick warning: this book is not suitable for all reflux sufferers. Also known as "Rapid Reflux Relief".
The Reflux Remedy Kit
This is a book + kit that presents some little known and creative natural remedies for heartburn and acid reflux. A good integration. Also known as "Heartburn & Acid Reflux Remedy Report".