Understanding GERD Symptoms
Usually, GERD symptoms are divided into two main groups: symptoms that affect the oesophagus, also called your gullet or food pipe, and symptoms that extend beyond the oesophagus into other areas of your body.
The most common symptoms of GERD that affect your oesophagus are heartburn and regurgitation.
Other common symptoms related to the oesophagus include:
- Burping often
- Chest pain
- Sore throat
- Water brash (excessive saliva mixing with stomach acid in the mouth)
In more advanced cases, GERD can lead to:
- The narrowing of the oesophagus due to scar tissue being formed (this is also known as oesophageal stricture)
- Difficulty swallowing
- Ulcers on your oesophagus
- Barrett’s oesophagus, a condition that slightly raises the risk of developing oesophageal cancer
GERD can also affect other organs beyond the oesophagus, like your voice box (larynx), your tummy, and your lungs.
GERD Chest Pain and Discomfort
In GERD, chest pain from heartburn and pain in your upper tummy, under your ribcage (epigastric pain) are common symptoms related to your oesophagus.
The burning chest pain happens because the lining of the oesophagus is over-exposed to refluxed stomach acid, which irritates it. GERD may occur for various reasons, including a weakened muscle barrier between your oesophagus and your stomach, excessive stomach acid, or because your stomach acid or stomach contents don’t empty or clear as they should. Sometimes, GERD can happen because some people are over-sensitive to even small amounts of acid.
Heartburn and GERD chest pain are usually experienced after eating (particularly after trigger foods like fatty meals or spicy foods) and tend to get worse when lying down or bending over. Symptoms may also worsen at nighttime or when eating too close to bedtime.
GERD Chest Pain vs. Heart-related Chest Pain
GERD chest pain can be easily confused with heart-related chest pain, as they are very similar. However, distinguishing between the two is very important, as chest pain can be serious or even life-threatening when caused by a heart condition, such as a heart attack.
Furthermore, GERD chest pain can sometimes coincide with a heart condition. Some studies have found a link between GERD and a raised risk of cardiovascular problems like arrhythmia and atherosclerosis.
So, it’s even more important to seek medical attention if you experience chest pain or discomfort.
See your physician if you have pain in your chest, and seek immediate medical attention if your chest pain is sudden or severe, or if it’s accompanied by other symptoms like feeling sweaty, sick, lightheaded, or out of breath.
Physical Symptoms Beyond the Oesophagus
GERD can lead to symptoms in other parts of the body beyond the oesophagus, including:
- Your throat and voice box/vocal chords
- Your tummy
- Your lungs
- Your back
- Your mouth, teeth, and gums
- Your ears and sinuses
Some of these symptoms, like the ones affecting your voice box (such as laryngitis) and your lungs (such as coughing), are atypical, meaning that they’re not very common or expected.
See your doctor if you have any of the atypical symptoms highlighted in this article.
Bloating and Abdominal Pain in GERD
GERD sometimes causes epigastric pain, or pain in the upper tummy. The pain happens as a result of the refluxed acid that irritates the oesophagus.
Other symptoms that may accompany abdominal pain in GERD include abdominal pressure, abdominal bloating, a sensation of fullness, and nausea. Some of these symptoms may be easily confused with other conditions, such as indigestion, or dyspepsia.
Throat and Voice
Due to repeated acid exposure, GERD can also end up affecting your throat and larynx, or voice box. This can cause the following:
- A sore throat
- A hoarse voice
- A sensation of lump in the throat (also called globus)
- Laryngitis (inflammation of the vocal chords)
- A chronic cough
- Frequent throat clearing
- Pain or difficulty swallowing
Referred Back Pain and Other Symptoms Beyond The Oesophagus
Occasionally, GERD may cause back pain. GERD back pain is referred pain, or pain that radiates from the original location to another spot. Back pain is an atypical symptom of GERD.
Other atypical and more serious symptoms of GERD include:
- Lung conditions such as pneumonia, asthma, or chronic bronchitis. These may occur when stomach contents are aspired into the lungs, raising the risk of lung infections.
- Oral symptoms, like gum disease, bad breath, and erosion of the teeth’s enamel. These happen when stomach acid and contents reflux all the way into the mouth, leading to tooth decay and inflammation of the gums.
- Conditions affecting the ears and sinuses, like sinusitis, earaches, or otitis. These can occur because your Eustachian tubes connect the throat to your middle ears.
These symptoms highlight the importance of assessing and treating GERD beyond its effect on the oesophagus.
Impact of GERD on Daily Life
GERD can significantly and negatively affect a person’s quality of life, especially if the symptoms are severe.
When GERD affects sleep, it interferes with work, productivity, and the ability to carry out daily tasks the next day.
Living with GERD pain and discomfort can affect not just your physical health but also your mental health.
Managing and Treating Physical GERD Symptoms
GERD can be managed through a combination of lifestyle and behaviour modifications, dietary changes, and over-the-counter medication.
Lifestyle Changes and Dietary Advice
There are many lifestyle changes that can help relieve GERD symptoms. Try the following tips to relieve your symptoms:
- Avoid wearing clothes that are tight around your waist
- Avoid lying down a couple of hours after your meals
- Find out your trigger foods by keeping a food diary and avoid them or limit them. Common culprits include citrus fruit, spicy foods and fatty foods
- Find out your trigger drinks and limit or avoid them. Common culprits include coffee, alcohol and carbonated drinks
- Avoid eating large meals infrequently and instead, try eating smaller meals more often
- Maintain a healthy weight through moderate exercise
- Make sure you get adequate sleep
- Quit smoking if you smoke
- Reduce or manage your stress levels
- Consider therapies like CBT to ease stress
To relieve nighttime GERD specifically, try the following:
- Avoid eating 2–3 hours before going to bed
- Sleep with your chest and head 10-20 cm above your waist by elevating the head of your bed
- Try sleeping on your left side instead of the right side or your back
Medication for GERD
There are many over-the-counter options available for treating GERD symptoms, such as:
- Alginates, like Gaviscon, which form a protective layer of foam on top of your stomach contents, keeping them from refluxing
- Antacids, which neutralise stomach acid
- Medications like Gaviscon Double Action, which are a combination of both antacids and alginates
- Proton-pump inhibitors (PPIs) such as Guardium, which block an enzyme that produces stomach acid
You may need a prescription for PPIs if you must take them for longer than a couple of weeks.
If PPIs don’t help, your doctor may recommend another type of medication.
Read more about what medication you can take for GERD.
Surgical Options
In more severe cases, when GERD symptoms do not respond to medications or lifestyle changes, they can also be treated with surgical interventions.
Your doctor will advise you on the best course of action depending on your symptoms, or they may refer you to a specialist for advice.
When to See a Doctor
See your healthcare professional if:
- You have heartburn 2 or more days a week, or most days a week
- Your symptoms feel troublesome or interfere with your quality of life and wellbeing
- You've tried relieving your symptoms with lifestyle modifications or over-the-counter medication, but they haven’t helped
You should seek prompt medical attention if:
- You’re often sick
- You get food stuck in your throat
- You've lost weight for no obvious reason
GERD causes classic symptoms like heartburn and regurgitation, but it can also cause atypical symptoms that extend beyond your oesophagus. These symptoms include chest pain, abdominal pain, and occasionally back pain.
See your healthcare professional if you experience heartburn on most days, and your symptoms haven’t gone away with simple lifestyle changes or over-the-counter medication.
Find out if GERD is a curable condition.
This article is for general information only and not intended as a substitute for medical advice. All information presented on these web pages is not meant to diagnose or prescribe. In all health-related matters, always consult your healthcare professional.
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