The contents of your stomach empty into the small intestine, but sometimes they flow backward into your esophagus. This phenomenon, known as gastroesophageal reflux, happens to everyone from time to time. It usually produces no symptoms other than occasional heartburn—a burning sensation behind the breastbone.
When gastroesophageal reflux occurs often, however, you may begin to experience significant discomfort related to the acid reflux—and that’s called gastroesophageal reflux disease (GERD). Many people in the United States have GERD: Heartburn affects about 10 to 20 percent of U.S. adults every day and more than 60 million people at least once a month. Symptoms of reflux are more common in individuals who are obese, smoke cigarettes, or drink alcohol.
GERD is a serious condition: The acid and digestive enzymes from the stomach can damage tissues in the esophagus as well as in adjacent organs such as the mouth, pharynx (throat), larynx (voice box), trachea (windpipe), and lungs.
Symptoms of GERD
GERD most often produces heartburn, indigestion (discomfort in the upper abdomen, nausea and sometimes vomiting), and regurgitation of undigested food from the stomach into the esophagus and mouth.
Acid from the stomach can even regurgitate into organs connected to the esophagus, such as the larynx, trachea, and lungs. This acid exposure can cause voice changes such as hoarseness, a chronic cough, episodes of asthma, or pain behind the sternum bone that resembles a heart attack. In some cases people with GERD experience those symptoms instead of heartburn and regurgitation, making diagnosis and treatment more difficult.
The chest pain associated with an intense episode of heartburn can feel like a heart attack. If you think you are having a heart attack, seek medical assistance immediately. Much of the damage done by a heart attack occurs in the first hour. Therefore, waiting to see if chest pain is due to heartburn could prove fatal.
Is it a heart attack or GERD?
How can you distinguish between a heart attack and GERD? Your chest pain is more likely to be heartburn if:
• It is accompanied by a bitter or acid taste in your mouth.
• You have symptoms such as belching and difficulty swallowing.
• If pain worsens when you lie down or bend over and it improves when you take an antacid.
But if the pain is accompanied by a cold sweat, a fast heartbeat, shortness of breath, or lightheadedness, and the pain radiates down one or both arms, there’s a good chance you’re having a heart attack.
Again, if you have any doubt about the cause of your chest pain, you should err on the side of caution and call 911 immediately, chew an aspirin, and lie down until an ambulance arrives.
To diagnose GERD, your doctor will perform an upper endoscopy as well as other tests to measure the motility and pH (acid concentration) of your esophagus.