Symptoms of Heartburn

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heartburn symptoms
© Verywell, 2018 

Occasional heartburn due to refluxed stomach acid is common, although you may wonder what it feels like if you haven't experienced it. Frequent heartburn is the most common symptom of gastroesophageal reflux disease (GERD) or acid reflux. Nighttime heartburn and GERD can lead to damage of the esophagus and both are risks for respiratory complications.

You will also want to get help for any unusual or severe chest symptoms that indicate a heart attack rather than acid reflux.

Frequent Symptoms

People have different heartburn triggers, but most people have similar heartburn symptoms:

  • Burning sensation in the chest: This burning sensation usually starts behind the breastbone (the sternum), and may travel up to the throat. It usually occurs shortly after eating and can last from a few minutes to several hours.
  • Burning feeling in the throat: There can be several causes of a burning throat, such as a sore throat or inflammation of the adenoids. A more common cause of this burning sensation is gastroesophageal reflux disease (GERD). This sensation is usually high up in the neck, though it can occur lower. The pain may worsen with swallowing. This burning sensation can result from irritation when stomach contents reflux up into the throat.
  • Sour or bitter taste in the mouth: This taste can occur when stomach contents reflux up into the esophagus and may reach the back of the throat. When the contents enter the back of the throat, a person will often have an unpleasant taste in the mouth.
  • Difficulty swallowing: Trouble with swallowing (dysphagia) occurs when food does not pass normally from the mouth through the esophagus to the stomach. There may be a sensation of food sticking in the throat, chest pressure, burning or choking after eating. Difficulty swallowing could be a sign of various conditions, including erosive esophagitis and esophageal cancer, and should always be evaluated by a physician.
  • Chronic coughing: Coughing can be caused when stomach acid refluxes (backs up) into the esophagus and is aspirated.
  • Wheezing or other asthma-like symptoms: GERD can affect asthma when stomach acid refluxes into the esophagus and is aspirated into the airways and lungs and can make breathing difficult and cause the patient to wheeze and cough.

Heartburn vs. Heart Attack

If you have unusual or severe sensations in your chest, it is important that you seek medical attention for a possible heart attack. Symptoms of a heart attack include chest pain, chest pressure, a cold sweat, fatigue, nausea, dizziness, or fainting. Don't wait or assume it may be heartburn—contact emergency medical help.

Complications

Heartburn is a common problem that can lead to serious conditions. It can also worsen some conditions, such as asthma.

Nighttime Heartburn

Nighttime heartburn can impact your health through disrupting your sleep, which contributes to many health and quality of life issues. Of more concern is that there are increased risks of damage to the esophagus when acid reflux occurs at night. There can be a greater risk of esophageal lesions and respiratory conditions.

The factors that can make nighttime heartburn more likely to cause damage include:

  • Sleeping in a supine position: Lying flat in bed allows stomach acid to flow more easily into the esophagus and stay there for longer periods of time than when a person is in an upright position. This is why it is suggested that you elevate your head and shoulders 6 to 8 inches if you have nighttime GERD.
  • You can't drink or swallow every time an acid reflux episode occurs when sleeping. When asleep, once the refluxed acid is in the esophagus or throat, you aren't always aware of it and thus you don't take steps to rinse the acid away.
  • There's an increased risk of choking on refluxed stomach contents. If refluxed acid is in the throat and mouth, a person with GERD can inhale this into the lungs and choke. The acid can also cause the same damage to the lungs as it can cause when refluxed into the esophagus.

    Asthma

    If you have asthma, GERD can lead to lung damage. Up to 75 percent of people with asthma also have gastroesophageal reflux disease (GERD), compared with 20 percent of the general population. It isn't known exactly how they are linked, but medications for asthma may worsen acid reflux. When you have both conditions you may not respond as well to medications intended to control each condition. However, controlling GERD can help relieve asthma symptoms. Heartburn contributes to asthma symptoms by injuring the airway linings, provoking a persistent cough, and may even trigger nerve reflexes that cause shortness of breath.

    Respiratory Complications

    Besides the effects in people with asthma, heartburn can lead to hoarseness, laryngitis, persistent dry cough, chest congestion, wheezing, and laryngitis. You may also be prone to pneumonia.

    Esophageal Damage

    When you have heartburn frequently for a long period you are likely to damage your esophagus. Inflammation (esophagitis) can become chronic and this can lead to narrowing of the esophagus (esophageal stricture) or precancerous changes. Barrett's esophagus can develop as there are changes in the type of cells lining your esophagus. Rarely, this can lead to esophageal cancer. Your risk of esophageal cancer is eight times as great if you have frequent heartburn and over 40 times higher if you have longstanding frequent heartburn.

    When to See a Doctor

    For any new symptoms of heartburn that occur more than twice a week and aren't relieved by over-the-counter antacids, you should see your doctor. It's never too late to make that appointment if you have chronic heartburn, either.

    Make an appointment with your doctor if:

    • Heartburn occurs more than twice a week
    • Symptoms persist despite use of over-the-counter medications
    • You have difficulty swallowing
    • You have persistent nausea or vomiting
    • You have weight loss because of a poor appetite or difficulty eating

    Your doctor will assess your digestive health and your heart health. The two of you can discuss a treatment plan that works for you.

    You should see your doctor immediately for the symptom of vomiting, especially if you have vomited a large amount, you frequently have forceful vomiting, or the vomited fluid is bloody, is green or yellow, or looks like it contains coffee grounds. Having problems breathing after vomiting is also an indication that you should see your doctor immediately.

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