Most of us have experienced gastritis and acid reflux, but Gastroesophageal Reflux Disease (GERD) is a chronic condition with sustained acid reflux and various health consequences. It happens when there’s an elevated amount or production of gastric juice that exceeds the tolerable limit and goes beyond the opening of the stomach refluxing into the esophagus and creating mounting injuries to the esophageal mucosa. The first stage of gastroesophageal reflux disease is acid reflux that goes chronic or neglected by the patient for a long time, and the last stage of this disease, when left untreated, is esophageal cancer.
Thus, it is important to pay close attention to sustained or recurrent symptoms of gastritis and acid reflux and report them to your doctor for a careful evaluation. It is also important to know the risk factors of esophageal cancer and other alterations of the gastrointestinal tube that typically result from gastroesophageal reflux disease.
In this article, we are going to cover the basic aspects of GERD as well as an introductory summary of the most common complications and how to detect them. The most important symptoms you need to pay attention to are:
1) Heartburn
There are many common symptoms between acid reflux and gastroesophageal reflux disease, and heartburn is probably the most important. As the name clearly implies, heartburn is a burning sensation in your chest that typically results from acid reflux. There’s a backward flow of stomach juices to your esophagus, and since the upper valve of your stomach reduces its normal activity, there’s not much obstacle for the acid to come out of the stomach when the patient is lying down.
Heartburn is typically felt after eating certain foods, especially spicy food, fried foods, and other fatty dishes. Therefore, it is important to include a series of lifestyle modifications that will significantly improve the symptoms of patients with chronic acid reflux or gastroesophageal reflux disease.
2) Regurgitation
In principle, gastroesophageal reflux is a regurgitation of stomach contents into the esophagus and other structures of the upper gastrointestinal tube. Along with heartburn, regurgitation has been defined as a dominant symptom of gastroesophageal reflux disease. We call regurgitation to the sensation that food, body fluids, and other particles are not flowing down to the stomach as they should but start to go back to the throat instead. It is different than nausea and vomiting because it does not always cause any belching symptoms. Instead, the patient has this uncomfortable feeling that he’s stuck and food is not properly led to the stomach.
This symptom is common because the upper sphincter of the stomach, which is called gastric cardia, becomes weaker and starts letting stomach contents pass to the esophagus. This is a serious issue that needs attention because, as you will see further in this article, it may become a risk factor to develop esophageal cancer, a disease that is highly asymptomatic apart from the symptoms we are describing in this article.
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3) Sore throat
We typically link a sore throat with pharyngitis and infections of the respiratory system. However, it may also be a symptom of acid reflux and gastroesophageal reflux disease. In both cases, the mucosa of the esophagus and the throat undergoes continuous injury because they are not prepared to withstand the acidity of the gastric juices and their lining is not anatomically made for this. Thus, the mucosa undergoes serious inflammation, and the patient reports a sore throat, usually led to believe they have a respiratory infection.
A sore throat in gastroesophageal reflux disease is often accompanied by hoarseness and coughing. The tone of the voice changes because the structure of the throat and its internal linings become thicker as a defense mechanism to withstand the acidity of the gastric juices. This, in turn, affects the vocal cords and changes the patient’s tone of voice.
4) Coughing
Gastroesophageal reflux disease and the first stage, gastric reflux, usually feature cough. Along with hoarseness and a sore throat, coughing makes the patient believe they have a respiratory problem and not GERD. In these cases, cough is sustained for a very long time, and it is typically one of the causes of consultation because it may even lead to abdominal pain as a result of the continuous strain. Coughing in gastroesophageal reflux disease is chronic and may also lead to worsening other symptoms such as the sore throat. It is not immediately relieved by antacids because it is a chronic alteration that requires an improvement in the medical condition over a prolonged period of time to reverse the inflammatory changes in the trachea and reduce the coughing reflux.
5) Chest pain
Patients with gastroesophageal reflux may feel chest pain instead of heartburn because there are different pathways and variations of pain and how it is felt between one patient and the other. In some cases, chronic coughing would also contribute to chest pain, and everything that triggers heartburn may worsen the symptom, as in consuming prohibited foods, eating large meals, and lying down.
However, chest pain should not be taken for granted, not even in patients with GERD. It may be indicative of heart disease, especially when it is felt as a pressing pain when it is severe or starts suddenly and rapidly escalates in intensity. Thus, if you feel there’s something wrong with your body, do not hesitate to call emergency services.
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6) Sleeping problems
Doing something as simple as lying down to sleep may worsen the symptoms in patients with gastroesophageal reflux disease. This is the reason why they usually report that their symptoms become worse at nighttime or when they are finally able to get back home and relax. This is because the gastric cardia, which is located in the upper portion of the stomach, becomes unable to hold gastric juices in place and they leak to the esophagus following gravity when the patient is lying down.
A common recommendation to improve the quality of sleep in patients with GERD is to lay down with the head above the level of the rest of the body. You can do this by placing pillows in your upper back and neck until reaching a comfortable position to get asleep without triggering acid reflux.
7) Difficulty to swallow
There’s an ongoing irritation of the esophagus, which is evidenced by a sore throat in patients with absolutely no respiratory infection. This irritation and inflammation of the upper part of the digestive tube lead to a symptom named odynophagia, which is basically pain upon swallowing, and other called dysphagia, which is trouble swallowing.
Odynophagia is triggered by the irritation of the esophagus and exposed nerve terminals in the affected area constantly sending signals of pain to the brain. Similarly, dysphagia is caused by swelling and inflammation in the area of the throat as well as thickening of the mucosa, which in time causes an alteration in the normal movements of the esophagus.
These two symptoms may seem trivial, but they are not firstly, because they may trigger anorexia (low appetite levels) and impair the nutritional state of the patient. Secondly, because dysphagia and odynophagia may be the hallmark of esophageal cancer, thus, it is important to report these symptoms to your doctor as soon as possible, especially when combined with others on this list.
8) An excess saliva production
This symptom is also known as water brash or acid brash, and it is common in gastroesophageal reflux disease when the gastric juices reach your throat. In these cases, the defense mechanism your mouth has to counter the effect of acid is creating and releasing more saliva. Similar to many other symptoms in GERD, it is possible to reverse water brash by eliminating foods that increase your stomach acid production such as alcohol, chocolate, fatty foods, and spicy foods.
9) A sour taste
Stomach acid is not a sweet substance to taste — quite the contrary. The excess of gastric juices that constantly flows to the throat area sometimes reaches the back of your tongue and may even go further. It does not only stimulate your papillary buds while acid is around, but may also start to change your perception of taste after a while. Thus, people start to feel a sour taste, especially when other symptoms are at their peak, as in heartburn, sore throat and coughing.
However, keep in mind that several medications may cause alterations in your taste, so leave the diagnosis to a health professional if you are having the symptoms we have described in this list. Experiencing a sour taste with heartburn, coughing, and problems swallowing in a single patient is suggestive of gastroesophageal reflux disease. However, your doctor may still need to perform various tests because even if we suspect the disease we need to know where it is coming from and how severe it is affecting your gastrointestinal tube.
10) Oral health problems
In many cases, the gastric juices do not only stop hurting the esophagus but may even reach your mouth and start breaking down the enamel in your teeth. Thus, your teeth become more susceptible to cavities and oral health problems, including inflamed gums and much more.
In these cases, and if you find symptoms such as heartburn and a sore throat linked with oral health problems, it might be necessary to schedule an appointment with your dentist and your general practitioner at the same time. Each one of them in their field of work will help you get back to your best state of health. Thus, do not neglect your condition, and if your problem has reached this level, do not leave it for tomorrow.
11) Belching and vomiting
Patients with advanced acid reflux and gastroesophageal reflux disease may experience nausea and vomiting, along with the appearance of other symptoms such as chronic cough and indigestion. You might find yourself frequently burping and sometimes even arching when the disease is at its peak point. In many severe cases, patients with GERD experience nausea and vomiting as well, and all of this is caused by the same inflammation in the throat area and the acidity of the gastric juices in a part of the gastrointestinal tube that is not anatomically prepared to withstand the chemical insult.
12) Sensation of a lump in your throat
Patients often come to the emergency room because they feel a lump in their throat, sometimes after eating, in other cases as a continuous symptom. Both scenarios should be carefully examined, and your doctor might need to see a contrast radiograph, an endoscopy study and various imaging tests to assess the ability of your esophagus to pass food and the integrity of the esophageal mucosa.
There’s a mobility disorder in the esophagus called achalasia. It happens when the damage to the esophagus is severe enough to impair the normal function of the neurons and their connection to the smooth muscle of the esophagus.
13) Vomiting blood
This is definitely an alarming sign for everybody, and if you have the symptoms we have described in this article along with bloody vomiting, it is highly suggestive of stomach ulcers. These ulcers develop as a response to sustained damage of the stomach lining by its own acid, and there are certain risk factors associated with them. The most important is an infection with Helicobacter pylori, a famous bacterium that invades your stomach and starts creating damage to the stomach wall.
If this is your case, you might not die right away, but it is still an emergency and needs to be solved right away. Complications of a stomach ulcer include stomach perforation, which is a lethal outcome we can all prevent by going to the doctor and following his recommendations.
It is impressive to see how a component in our own physiology can become a source of severe injury. Gastritis and acid reflux are common problems, and they are often neglected and not correctly solved. Most of these symptoms are shared by acid reflux in its early stages, but patients do not pay much attention, and the problem goes chronic with devastating consequences. Thus, if you have checked the majority of these signs and symptoms talk about it with your general practitioner and do not be afraid of diagnostic tests.
References
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Buttar, N. S., & Falk, G. W. (2001, February). Pathogenesis of gastroesophageal reflux and Barrett esophagus. In Mayo Clinic Proceedings (Vol. 76, No. 2, pp. 226-234). Elsevier.
Vakil, N., Van Zanten, S. V., Kahrilas, P., Dent, J., & Jones, R. (2006). The Montreal definition and classification of gastroesophageal reflux disease: a global evidence-based consensus. The American journal of gastroenterology, 101(8), 1900.
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