The condition called heartburn is a burning sensation that starts from the stomach and can be felt directly behind the sternum and even as far away as the throat. It is often most intense after eating a large meal or when the body changes position - especially when lying down on the back. Although heartburn is the primary symptom of acid reflux disease, it is a common condition. Unless other acid reflux symptoms are noted, heartburn does not always indicate acid reflux disease.

The heartburn associated with acid reflux may be severe, and is often the presenting complaint. It is very important to have a doctor evaluate any severe chest pain so that a differential diagnosis can be made between pain caused by reflux and cardiac related pain, such as angina or infarction. With reflux disease, the severe chest pain is often seen at night, due to postural changes as noted above.

The second most common symptom is dyspepsia, a chronic or recurrent pain centered in the upper abdomen. As with other acid reflux symptoms, the extent or expression of dyspepsia is varied and does not indicate the extent of damage to the esophagus. This pain may be accompanied by nausea and vomiting, or may express itself as only a sensation of fullness in the stomach. Again, dyspepsia may be present without reflux.

The second most frequent acid reflux symptom is regurgitation, the abrupt experience of the contents of the stomach flowing back up the esophagus into the mouth or throat. In extreme cases, the stomach contents may be belched or expelled. Such regurgitation is sometimes associated with nausea. However, sporadic regurgitation, especially in children, is not itself an indication of reflux disease.

There are many symptoms of acid reflux disease. Some of the less common ones may include coughing, wheezing, hoarseness, sore throat, stuffy head, or hiccups. Chronic nausea may also be present and may persist off and on for months. These are not the usual symptoms of acid reflux but may be present in certain cases and should be considered as warning signs.

Fortunately, most primary care physicians can easily diagnose acid reflux disease, but sometimes complicated situations can make the doctor unsure. In this case, a diagnosis can usually be reached by using a trial dosage of medication that will temporarily prevent the stomach from secreting acid. It is important to rule out all other conditions that might be suggested by the many symptoms of reflux before definitively diagnosing reflux disease.

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