Hoarseness, difficulty swallowing, a persistent cough and even asthma are symptoms of GERD, says UCI Health gastrointestinal surgeon Dr. Brian Smith.
We’ve all seen the heartburn commercials: They usually show a man grimacing in pain, a hand on his chest and maybe another over his mouth.
More than 15 million U.S. adults suffer daily with heartburn, while another 60 million people experience it at least once a month.
Heartburn — also called acid indigestion — is the most common symptom of gastroesophageal reflux (GER) and chronic acid reflux, known as gastroesophageal reflux disease (GERD). It occurs when acid or other stomach contents flow back into the esophagus. But it's far from the only indicator of GERD.
“There are other, less common symptoms that people don’t typically associate with chronic acid reflux,” says Dr. Brian Smith, a gastrointestinal surgeon with the UCI Health Chao Digestive Health Institute.
How heartburn feels
“We’ve all heard of heartburn,” says Smith. “But if you haven’t experienced it, you may not know how painful it can be.”
Acid indigestion is characterized by abdominal pain or a burning sensation that radiates into the chest along the path of the esophagus. It can last a few minutes or linger for several hours.
“Although we mostly see acid reflux, not all reflux is acid,” Smith adds. “Sometimes bile — a bitter greenish-brown fluid secreted in the stomach to aid digestion — is the culprit. Although less common, bile is also extremely irritating to the esophagus and its symptoms are more severe.”
GERD affects 10% to 20% of Americans and it is more common among adults age 50 and older.
Although GERD is rarely life-threatening and is very treatable, it can wreak havoc on a person’s quality of life, what they can eat or drink and how they sleep. Left untreated, it can lead to more serious conditions such as Barrett's esophagus and esophageal cancer.
GERD's other symptoms
Heartburn as depicted on TV is not the only way you can experience GERD.
Many lesser-known symptoms are related to how far the food, acid or stomach bile travels up the esophagus. They include:
- Swallowing problems. Difficulty swallowing can be a symptom of acid rising into the esophagus.
- Throat and voice issues. Throat clearing, hoarseness, a persistent cough or laryngitis may be caused by acid refluxing into the upper digestive tract, affecting the throat and vocal cords. This is known as laryngopharyngeal reflux (LPR).
- Salivation and stomach discomfort. Excessive production of saliva, gas and bloating.
- Regurgitation. Nearly 70% of GERD patients experience regurgitation of food or stomach acid.
- Sour taste. About 40% of GERD sufferers complain of a sour, unpleasant taste in their mouth or the back of the throat. Also known as water brash, it is caused when saliva mixes with stomach acid.
- Asthma. Even asthma can be a sign of LPR. Some studies suggest that up to 80% of asthma patients also have GERD.
- Sinus problems. Sinus irritation or ear and nasal discomfort is another rare indication of LPR, affecting 5% to 10% of people with GERD.
People who have symptoms of LPR — indicated by a raspy voice, chronic cough, constant throat clearing and persistent sinus irritation — should seek a referral to an ear, nose and throat (ENT) specialist for a nasal endoscopy, Smith says.
Coping with acid reflux
Smith says patients typically deal with acid reflux by:
- Sleeping with the head elevated
- Washing food down with water or milk
- Avoiding trigger foods like chocolate, peppermint, tomato sauce, orange juice, fried or fatty foods, coffee and alcoholic beverages (red wine, in particular)
Many over-the-counter and prescription medications can also help alleviate acid reflux, he adds.
When to see a doctor
However, Smith says, people should seek specialized care when their discomfort and symptoms escalate to:
- Chronic GERD (for more than five years)
- Weight loss
- Early feelings of fullness when eating
- Persistent difficult or painful swallowing
These are signs that you should talk with your primary care provider about a referral to a gastroenterologist for an endoscopy to examine the upper digestive system, Smith says.
“At the Chao Digestive Health Institute, we strive to provide comprehensive, one-stop expertise in testing and treatment that both educates patients and places them in charge of their treatment plan.”
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