The stomach is a very complex structure. It handles an incredibly high amount of acid without affecting its walls. It’s an exception to the rule because if the stomach contents were to spill into the abdominal cavity, the strong acid and digestive enzymes would destroy everything on their way. The stomach has complex molecular reactions that protect its walls against damage, but when the equilibrium is lost, gastritis, acid reflux, and other peptic problems ensue.
Acid reflux is often how these problems with stomach acidity start. Instead of staying in the stomach, the gastric fluids travel through the esophagus, which is not prepared and does not have the metabolic machinery to counter the effects of acid. In some cases, acid reaches the throat and causes more noticeable signs and symptoms.
Acid reflux can be an episodic problem affecting patients after eating a fatty meal or a more permanent ailment called GERD. In Gastroesophageal Reflux Disease (GERD), patients have a chronic condition, permanent issues with acid reflux, and different problems that come along and complicate the disease.
In this article, you will find the most important signs and symptoms of acid reflux, which is sometimes an isolated episode but can also be included in a chronic disease known as GERD.
Acid reflux symptoms
The signs and symptoms are:
1. Heartburn
The stomach pain that is often associated with an increase in acid is not very different from that of gastritis. Patients report a burning or dull pain, sometimes just an abdominal discomfort, located between the belly button and the breastbone, right in the middle line of the abdomen. They often feel more pain when the stomach is empty, and this dull pain is often confounded with hunger and other unpleasant sensations. It is very common to have a sleepless night or stop in the middle of the night with burning pain.
This burning abdominal pain is caused by the increased acidity in the stomach and the continuing wear down of its walls. The internal lining of the stomach does not have nerve terminals and does not cause pain directly. Instead, the escalating injury to the stomach starts to release inflammatory substances, and this inflammation in the abdominal cavity triggers the nerve terminals located throughout the abdominal wall. That’s why the pain sensation is poorly located but placed near the stomach.
Another characteristic of this pain is that it is often relieved by taking antacids and sitting up instead of lying Patients may find some relief by sipping on cold water, but this may have a rebound effect after a while.
2. Regurgitation
This is also an essential symptom along with the pain. Regurgitation means that the contents of the stomach return to the esophagus and sometimes reach the throat causing a sensation similar to that of vomiting. But why does it happen? For the same reason that acid regurgitates: there’s an alteration in the stomach sphincter, which is supposed to close the lid and prevent this from happening.
This sphincter is a ring-like muscle that divides the stomach and the esophagus. It is called cardia. A signal goes through the esophagus when you swallow your meal, and the sphincter opens to allow food in. It rapidly closes to prevent regurgitation. But in some patients, the cardia muscle weakens, and its function is lost. This leads to a continuous return of stomach acid to the upper portions of the gastrointestinal tract.
3. Bloating
Acid reflux can also be very annoying because it causes abdominal discomfort when your stomach is full, especially after a large meal. It is common to experience bloating and burping after a large meal, and patients often describe this sensation as indigestion. Even a medium-sized meal will cause the same effect when the disease aggravates.
It is also described as a heavy feeling in the abdomen or the stomach right after eating and often goes along with a round and tight belly. However, this is a prevalent symptom in many diseases, such as lactose intolerance and inflammatory bowel diseases. That’s why it is essential to visit your physician to get a complete check-up that will give a professional a clear picture of your problem.
4. Nausea
Another common symptom associated with acid reflux is nausea, which sometimes leads to However, these are only persistent when the condition worsens and might stay around for several hours. Occasionally, patients would feel sick closely after having a large meal, and several hours after, they would start vomiting the contents of their previous meal.
By itself, nausea is not meant to be a warning sign. Still, if you experience burning pain on an empty stomach along with nausea and bloating after having a meal, you should probably schedule an appointment with your doctor.
5. Sore throat
Sometimes, acid reflux in GERD can be confused with upper respiratory infections because it causes similar symptoms. You can get a sore throat after an episode of GERD. This is because the epithelium in your esophagus, pharynx, and larynx are not prepared to have stomach acid around, and they undergo a chemical burn. Inflammation ensues, and the tissue becomes tender and painful. A sore throat can sometimes be severe, and it is usually accompanied by hoarseness.
In the long term, if you stay with this problem and do not receive treatment, you can have severe disease complications. One of the most feared complications is Barrett’s esophagus. The esophagus lining tries to change its configuration to defend from the constant insult. In doing so, it becomes susceptible to developing esophageal cancer.
6. Coughing
During an episode of acid reflux, and depending on the severity of your problem, you might start coughing uncontrollably. This is a dry cough without mucus, and it is initiated by your esophagus because your body is trying to get rid of the acid. It is a reflex, and it is sometimes improved by using antacids.
7. Chest pain
In some cases, GERD can also be confused with a heart attack because pain is sometimes not located in the upper portion of the abdomen. You can experience referred pain in the chest, especially in more severe cases of the disease and after a large meal. In some cases, you might be able to detect it is due to acid reflux, but in general, it is always a good idea to report chest pain, especially if the symptom is severe.
8. Difficulty swallowing
Patients with stomach acid problems also often experience swallowing issues. The ongoing injury to the stomach wall and the high acidity of the stomach juice cause a persistent inflammatory state in the stomach and the upper part of the gastrointestinal tract. Inflammation escalates, and patients often develop complications of gastroesophageal reflux disease and even stomach cancer.
Gastroesophageal reflux features a constant regurgitation of stomach contents to the esophagus. It’s often felt like a burning pain that runs upwards to the throat. In the long term, the acidity of the gastric juice on the esophagus causes an injury to the tissue. The esophagus becomes hard and thick and loses its function, which is why patients start feeling difficulty swallowing.
9. Sleeping problems
Lying down to take a nap or sleep at night can sometimes trigger more severe symptoms in patients with acid reflux. This happens because the cardia sphincter is weak, and the stomach contents fall victim to gravity. Thus, symptoms at night are usually more severe, and patients may need to use special pillows to maintain their heads above the rest of the body. Patients with gastroesophageal reflux usually have insomnia during acute episodes.
10. Sour taste
The taste of stomach acid is not sweet. Thus, you can easily understand how the taste changes when you have stomach acid around. Gastric juices are flowing upward to the throat constantly. In some cases, they make contact with a portion of the tongue, stimulating the papillary buds and changing the patient’s taste perception. So, even when you don’t have active acid reflux, your taste perception might start to change.
But the sensation is much more prominent in acute episodes. Other alterations may also change your taste. Thus, it is essential to talk to your doctor about it. In some cases, it can be due to a medication. But if you have other signs and symptoms listed in this article, acid reflux is always a possibility.
11. Dental issues
Gastric juices and acid can reach the other parts of the mouth after hurting the esophagus and creating a sour taste. When it reaches your teeth, the acid breaks down the enamel and causes a series of dental health problems. It would also inflame your gums and create several oral issues.
When acid reflux symptoms are associated with dental problems, it is probably because the alteration is very severe. A dentist should evaluate this problem, but you should also make an appointment with your doctor.
12. A lump in the throat
Another important symptom during an acute episode is a sensation of a lump in the throat. Patients often report this symptom after eating a large meal, especially fatty food. This symptom should be examined carefully to rule out other diseases. In some cases, imaging tests or an endoscopy might be required.
Patients with esophageal mobility issues may also experience this sensation. It is called achalasia, which happens when the neurons or the muscle tissue of the esophagus stop working as it should.
Signs and symptoms of acid reflux comorbidities
Acid reflux is usually not an isolated problem. In most patients, it coexists with associated diseases such as gastritis and peptic ulcer. They contribute to additional symptoms, making acid reflux a more complex problem.
13. Lightheadedness and weakness
Susceptible patients often experience a progressive decay in the event of GERD episodes, especially in the case of the elderly with a peptic ulcer. Sometimes, peptic ulcers would start bleeding slowly and steadily. It’s an open ulcer that will not heal, so it becomes long-term bleeding that progressively weakens patients after their sustained blood loss.
Lightheadedness and weakness are caused by peptic ulcer-related anemia. The gradual loss of blood reduces the total red blood cell count because there’s a higher rate of blood loss than new blood creation.
These cells contain hemoglobin, a particular protein that carries oxygen from the lungs to the rest of the tissues. When it starts declining, the blood becomes diluted and fails to deliver oxygen to the organs. The brain is given priority in terms of blood flow. Still, if the condition becomes severe enough, it affects how much oxygen the brain receives, reducing our mental capacity.
Patients often report a sudden blackening of their vision when they change positions or stand up after lying down, which might be influenced by their anemia and reduced blood volume, resulting from internal bleeding.
14. Vomiting blood
We didn’t list vomiting blood at first because it is often a late consequence of a complication of acid reflux, especially in the case of a peptic ulcer. However, vomiting blood is one of the classic signs of a peptic ulcer because internal bleeding of the ulcer is often the first complication to arise.
Internal bleeding is a common complication, primarily when the ulcers are near blood vessels. Vomiting blood is the sign of a rapid and severe hemorrhage that’s very profuse and cannot be contained by the stomach.
There are other causes of vomiting blood, but peptic ulcers are one of the most common. Still, it is necessary to perform an endoscopy to diagnose the problem and stop the hemorrhage. Thus, if you’re vomiting blood, you should not wait for it to stop or take medications. Instead, seek urgent medical assistance to solve your health problems immediately.
15. Tar-like stools
If you’re vomiting blood, you probably have tar-like or darkened stools as well. However, sometimes patients report black stools without any episode of bloody vomiting. Tar-like stools are caused by blood that’s been spilled inside the digestive tract and goes all the way down to be eliminated in feces. It’s denaturalized and decomposed, which is why it also has a foul smell.
People who experience tar-like stools without any blood vomiting might have severe bleeding that’s not rapid enough to exceed the stomach’s capacity. But another common cause would be internal bleeding in a lower portion of the gastrointestinal tract (as in the duodenum or the large intestine). Thus, we should visit a doctor and perform the appropriate exams to get a diagnosis and start proper
16. Loss of appetite
In some exceptional cases, acid reflux and its complications can cause painful digestive system inflammation and initiate gastric outlet obstruction. In these cases, food is obstructed and cannot go further in the gastrointestinal tract, which is why patients would feel a sensation of fullness shortly after starting to eat, loss of appetite, severe bloating, and a persistent heavy sensation in the abdomen.
In many cases, patients also experience explosive vomiting with very large amounts of undigested foods. This usually leads to several other nutritional complications and may turn into a life-threatening event in susceptible individuals, especially the elderly.
17. Unintended weight loss
Closely associated with loss of appetite, many patients with acid reflux and peptic disease would experience an involuntary weight loss usually caused by a reduced intake or a reduced capacity of the gastrointestinal tract to digest food properly.
Unintentional and dramatic weight loss should always be an alarming sign, and we should carefully look at the root causes. There are many possible reasons, and only a qualified doctor would be able to sort them out and reach a proper diagnosis to start treating your condition.
Conclusion
As you can see, acid reflux can be a mild or very severe problem, depending on different factors. Stomach acid is beneficial for us. It contributes to digestion, and we don’t want our stomachs to stop producing acid. The problem is when physiology is altered, and the acid reaches the esophagus.
Acid reflux, gastritis, and other stomach problems are common but should not be neglected. Doing so leads to complications such as GERD, Barrett’s esophagus, stomach cancer, esophageal cancer, peptic ulcer, stomach perforations, and peritonitis. Thus, trust your doctor instead of trying to solve the problem yourself. That’s definitely the best option to prevent more severe symptoms and their devastating consequences.
Acid reflux treatment should include lifestyle modifications and medications to control gastric acid secretion. They include antacids but also protein pump inhibitors. In some cases, patients may also need corrective antireflux surgery. In most cases, patients with GERD will control their symptoms with medications only. Only 20% of patients develop more advanced conditions, including Barrett’s esophagus. These patients need more specific treatment for their condition, and a proportion of them may also develop signs and symptoms of esophageal cancer.