Heartburn, a burning sensation that radiates from the stomach to just behind the sternum or even to the throat, is the primary symptom of acid reflux disease. Heartburn is typically worse after a heavy meal and during postural changes, especially while lying on the back. Occasional heartburn is common and not necessarily indicative of reflux disease, unless other acid reflux symptoms are noted.

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.

Dyspepsia, a recurring pain radiating from the upper abdomen, is the second most common of acid reflux symptoms. Just like other symptoms, the evidence of dyspepsia, including any damage to the esophagus, is not consistent or predictable. The patient may only feel a sense of fullness in the stomach area, or may experience vomiting and nausea. It is possible to experience dyspepsia without reflux.

The next most common of the acid reflux symptoms is regurgitation, a sudden feeling of the stomach contents flowing back up the esophagus into the throat or mouth. In severe cases, the contents may actually be burped or even vomited. Regurgitation may or may not be associated with nausea. Occasional regurgitation occurs, especially in children, and by itself does not indicate reflux disease.

There are many other less common symptoms of acid reflux disease. Typically, these involve a rough unproductive cough, wheezing, hoarseness or laryngitis. Less common symptoms are a constant feeling of having a lump in the throat or chronic sore throat, sinusitis, and persistent hiccups. Even more uncommon is chronic nausea that is not associated with any other of the reflux symptoms. This nausea may be intermittent persist for months.

Usually a diagnosis of acid reflux disease can be made without difficulty by a primary care physician. However, the multitude of symptoms that manifest in acid reflux requires that all differential diagnosis should be ruled out before declaring a definitive diagnosis. When a difficult case presents itself, a trial dosage of medication to temporarily stop stomach acid secretion often produces a clear diagnosis.

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