Many people use the two terms interchangeably, but heartburn and acid reflux are not the same thing. In fact, heartburn is a symptom of acid reflux, a condition in which stomach acid sneaks back up into the esophagus. While heartburn is one of, if not the most common sign of acid reflux, there are many other surprising acid reflux symptoms you should know about.
Acid reflux is quite common, but most people only experience it occasionally, typically after eating certain foods. According to the American Gastroenterological Association (AGA), reflux can be triggered by fried or fatty foods, chocolate, tomato sauce, alcohol, coffee, carbonated drinks, and vinegar. If you are dealing with acid reflux two or more days per week, it’s considered gastroesophageal reflux disease (GERD), per the National Library of Medicine (NLM).
Meet the expert: Joseph Murray, M.D., a gastroenterologist who researches esophageal disorders at Mayo Clinic.
Some symptoms of acid reflux are easy to tie to the condition, while others are more surprising. “I also see reflux being blamed for symptoms that have nothing to do with it,” said Joseph Murray, M.D., a gastroenterologist who researches esophageal disorders at Mayo Clinic. That’s why it’s helpful to know both the common and the rarer symptoms of acid reflux, plus when you might want to give your doctor a call. Read on to learn more.
Possible signs of acid reflux
Chest pain
It may be cliché to confuse heartburn and heart attacks, but it really does happen. “It’s not uncommon to see someone in the ER with terrible chest pain, thinking it’s a heart attack when it’s actually reflux,” Dr. Murray said. Unfortunately, the opposite also happens—sometimes with tragic results. “Someone is having a heart attack, but they don’t go to the ER because they figure it’s indigestion,” he said.
One typical heart attack symptom is tightness or pressure in the chest, arms, or neck that accompanies the chest pain, something that does not occur with reflux or GERD, per Mayo Clinic. When in doubt, go to the emergency room.
Excess saliva
If your mouth is flooded with saliva after eating, that could be a sign of acid reflux, Dr. Murray said. Much like how your mouth starts watering before you vomit, your salivary glands kick into high gear when they detect an irritant in your throat. They’re preparing to wash away whatever’s down there—or about to come up.
Wheezing or trouble breathing
If you experience problems breathing—especially at night when you’re lying down—reflux may be to blame. “When you lie down, acid washing up into the esophagus can trigger a reflex that causes wheezing,” Dr. Murray explained. “The acid can also go into airways and cause direct irritation, so you could be waking up choking and coughing.” Per the Cleveland Clinic, trouble breathing can also occur after a large or fatty meal, after bending over, or after smoking or drinking alcohol. But if it comes out of the blue, there may be something else going on.
Regurgitation
Another sign of reflux, per the AGA, is feeling food come back up after you’ve eaten it. That’s not quite the same as throwing up—it’s more like a strange sensation that something is creeping up your throat into the back of your mouth without coming all the way up and out.
Sour taste
The stomach juices that make their way up into your throat can also leave a sour or acidic taste in the back of your mouth, according to the Cleveland Clinic. If eating seems to spur a bitter taste in your mouth, acid reflux may be the culprit.
Lump in your throat
Constantly feeling like there’s a lump in your throat could be a sign of chronic reflux, especially when combined with other symptoms, according to the AGA. But that’s not always the case, Dr. Murray said, as “dust or irritants” could also be to blame for your constant throat-clearing.
Burping
Frequent burping is a sign that food could be making its way back up your esophagus, per the AGA. Chronic burping might also be caused by the increased swallowing associated with GERD, according to the Mayo Clinic.
Difficulty swallowing
“Reflux can cause a narrowing of the throat due to damage and scarring, so food is actually being held up on its way down,” Dr. Murray said. This can feel like your food has grown claws and is scratching your throat as it heads toward your stomach, so swallowing feels more painful or difficult than it should.
Nausea
It makes sense that reflux would cause nausea, especially if you feel sick after eating. The condition is rooted within your digestive system, after all. While chronic nausea isn’t necessarily related to acid reflux, it is one of the more common signs, per the Cleveland Clinic.
Coughing or sore throat
One specific kind of acid reflux, laryngopharyngeal reflux, can cause lesser-known symptoms like coughing, hoarseness, and a sore throat. And if you have it, you may not experience more classic signs like heartburn or indigestion, per the Cleveland Clinic.
But Dr. Murray cautioned against jumping to conclusions. “Too often, a doctor sees a red throat and starts treating it with heavy-duty acid-blocking drugs,” he said. If you try those drugs for two weeks and don’t notice an improvement, “something else may be going on,” like allergies or a sinus infection.
When to see a doctor about your acid reflux
Acid reflux isn’t life-threatening. But some symptoms suggest the condition has become chronic, putting you at higher risk of experiencing complications. When stomach acids escape your belly, they don’t just irritate your throat—they can also make their way into your lungs. This can leave you with “a nasty case of pneumonia,” Dr. Murray said. What’s more, people with GERD have a slightly higher esophageal cancer risk.
According to the National Institutes of Health, GERD can result in more serious complications in addition to the symptoms above. Talk to your doctor if you experience a loss of appetite, persistent vomiting, problems swallowing, unexplained weight loss, vomit that looks like coffee grounds, or bloody or black stools. (The last two symptoms are signs of bleeding in your digestive tract.)
Chest pain can also signal heart trouble, meaning you should seek immediate medical attention if you suspect you may be having a heart attack.
Acid reflux can also have a big impact on your quality of life, even without these potentially dangerous complications. Cutting out trigger foods and taking over-the-counter antacids might be enough to quiet your unruly stomach acids, but your doctor can also help you find the best treatment plan for you. Next steps might include prescription-strength options, like proton-pump inhibitors, if lifestyle changes and OTC medications don’t assuage your symptoms.
Additional reporting by Jake Smith and the editors of Prevention
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