I’ve been experiencing a burning sensation in my chest after eating, and I think it might be acid reflux. Everyone always talks about heartburn being the main symptom, but I’m wondering if that’s the only sign. Can acid reflux manifest in other ways? I’m also curious if the severity of the symptoms always correlates with the amount of acid escaping into the esophagus, or if someone can have significant damage without intense heartburn, and vice versa. So, to be clear: Is heartburn the only symptom of acid reflux, or are there other, less commonly known symptoms to watch out for, and how does symptom severity relate to the actual extent of esophageal damage?

Answer

Heartburn is a common and often primary symptom of acid reflux (also known as gastroesophageal reflux or GER), but it is not the only symptom. Acid reflux occurs when stomach acid flows back up into the esophagus.

Other symptoms of acid reflux can include:

• Regurgitation: The sensation of stomach contents, including food or bitter-tasting acid, moving up into the chest or throat.
• Dysphagia: Difficulty swallowing. This can be caused by inflammation or narrowing of the esophagus from chronic acid exposure.
• Chronic cough: Acid reflux can irritate the airways, leading to a persistent cough, especially at night.
• Laryngitis or hoarseness: Acid reflux can irritate the vocal cords, causing inflammation and hoarseness.
• Sore throat: Similar to laryngitis, acid can irritate the throat.
• Globus sensation: The feeling of a lump or something stuck in the throat, even when nothing is there.
• Nausea: A general feeling of sickness or unease in the stomach.
• Excessive salivation (water brash): The sudden production of saliva in response to acid in the esophagus.
• Asthma symptoms: Acid reflux can trigger or worsen asthma symptoms.
• Dental problems: Acid reflux can erode tooth enamel, leading to cavities and sensitivity.
• Chest pain: In some cases, chest pain due to acid reflux can mimic heart attack pain. This can occur because the esophagus is located near the heart, and nerve signals in that region can be confusing.
• Sleep disturbances: Acid reflux symptoms can be worse at night, leading to disrupted sleep.

These symptoms can vary in severity and frequency from person to person. Some people primarily experience heartburn, while others may have more atypical symptoms, especially if they have silent reflux (laryngopharyngeal reflux or LPR) where heartburn may be absent or minimal. In LPR, the reflux primarily affects the larynx and upper airways.

If left untreated, chronic acid reflux can lead to more serious complications, such as esophagitis (inflammation of the esophagus), esophageal strictures (narrowing of the esophagus), Barrett’s esophagus (a precancerous condition), and an increased risk of esophageal cancer.