Gerd Symptoms*

GERD causes problems in the esophagus, the pipe that brings food from the mouth to the stomach.  For this reason, most symptoms are felt in the throat area.  Patients probably have GERD if they feel burning in their chests or throats, or taste something sour in their mouths when they’re not eating. They can also have chest pain, either on the left side near the heart or the right side opposite the heart — and have trouble swallowing.

Other symptoms include an excess of saliva in the mouth (water brash), a dry, and hacking cough with no mucus, sore throat, a hoarse voice, and the spitting up of food known as acid reflux. GERD patients sometimes feel like they have lumps in their throats.

Because of chest pains, acid reflux can be confused with the symptoms of heart attacks.  If patients also have trouble catching their breath, and feel their jaws or arms hurting, they may be having cardiac arrest and should see a doctor right away.  A doctor’s visit is also necessary if any of the following GERD symptoms are severe and/or frequent.

The most common GERD symptom is heartburn; chest pain that intensifies when a patient eats, bends, stops, or lies down. Sometimes a GERD patient can feel, as there is food sitting immobile behind the breastbone instead of sliding down to the stomach where it belongs.  In GERD cases, heartburn symptoms first appear about two hours after eating, and they hit particularly hard at night.   Fortunately, antacids can relieve the pain from heartburn temporarily, although they don’t prevent acid reflux.  However, if the heartburn goes on for an entire afternoon or evening, or all night, the GERD is probably quite severe.

GERD can also cause nausea after eating, because the food from a meal doesn’t get digested properly.  In particularly bad cases, patients can wheeze and cough, get hoarse, have trouble swallowing, get a sore throat and spit up their food.    When the juices and acids from the stomach spill back into the esophagus, patients can also have a persistent sour or bitter taste in their mouths.   Sometimes this taste is the only noticeable symptom.

All these individual symptoms — heartburn, bad aftertastes and so forth — occur sometimes in healthy people.  If GERD symptoms are limited to heartburn, the patient has a mild case which can be treated successfully at home with lifestyle and diet changes, and the judicious use of over-the-counter antacids such as Tums, proton pump inhibitors, or H2 blockers.   However, when episodes of heartburn occur twice a week or more, or for extended periods, more specialized treatment may be necessary.

Slightly less than half of GERD patients develop esophagitis, the inflammation of the esophagus, which causes symptoms of its own — pain when swallowing, mouth sores, nausea, vomiting, and a sensation of lumps in the throat.    Like the milder symptoms mentioned above, other diseases, such as yeast infections, herpes, or hernias, can cause esophagitis.  If the esophagus is inflamed but not infected, the esophagitis can be treated with anti-inflammatories, such as corticosteroids. More severe esophagitis may require surgery or endoscopy.

Advanced GERD has symptoms far more severe than heartburn or inflammation.  When the esophagus is under prolonged and constant attack by stomach acids, the esophageal lining can break down, or erode, causing ulcers.  The ulcers and inflammation can, in turn, cause bleeding. Chronic inflammation stimulates the development of tough, thick scar tissue, which results in a narrowing of the esophagus known as stricture.   When the esophagus is damaged to this extent, it also affects the respiratory system, causing chronic coughing and asthma attacks, and can change the structure of the lungs.  Thus, advanced GERD patients may become hoarse and are susceptible to laryngitis.   If stomach acids back up frequently into the mouth, they may cause premature tooth decay by eroding tooth enamel.

The most severe side effect of advanced GERD is probably a condition called Barrett’s esophagus, which is asymptomatic but potentially deadly because of its connection with cancer.  GERD patients with chronic heartburn are the group most likely to develop Barrett’s esophagus.   In this medical condition, the tissue that lines the esophagus goes through a structural change called intestinal metaplasia, in which its cells are replaced with cells characteristic of the lining of the intestine.   Between 5 and 15% of heartburn patients have Barrett’s Esophagus, and of these patients, about 1 in 200 (0.5%) go on to develop a deadly cancer of the esophagus.  White males over fifty are the population most likely to develop cancer as a result of Barrett’s Esophagus.   Although it is impossible to predict which Barrett’s Esophagus patients will develop cancer, there is clearly a relationship between the two.  One more reason, then, to treat GERD in its early stages, before the damage progresses too far.

*This article is based on the information at http://www.mayoclinic.com/health/gerd/, http://www.nlm.nih.gov/medlineplus/ency/article/000265.htm, http://www.webmd.com/heartburn-gerd/tc/gastroesophageal-reflux-disease-gerd-symptoms, http://www.gerd.com/, ttp://www.medicinenet.com/gastroesophageal_reflux_disease_gerd/article.htm

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