Acid Reflux Symptoms & Warning Signs

By Tom Iarocci, MD. May 7th 2016

Acid reflux affects both adults and children. In fact, some reflux up from the stomach is a normal process…unless it occurs frequently enough to cause damage, or causes symptoms that interfere with a person’s wellbeing or quality of life.

With adults, symptoms are easier to recognize since children may have trouble explaining the symptoms that they are experiencing. Most commonly, adults will feel heartburn, the sensation of intense burning in the chest under the breastbone and upward. This burning pain or discomfort might intensify with changes in position such as lying down or bending. When symptoms are mild and very infrequent, antacids may provide some relief.

You might notice that your heartburn occurs after you eat certain foods or for no reason at all. You may experience heartburn in the morning, at night, or throughout the day. No matter when you experience heartburn, if you experience the symptom for multiple weeks, then you could have acid reflux.

But sometimes, the symptoms of acid reflux are difficult to distinguish from other conditions such as indigestion and stomach ulcers. If you have indigestion, then your heartburn may occur more sporadically. Stomach ulcers, on the other hand, can produce symptoms that last for a period of several weeks. A detailed examination is necessary to determine whether you are experiencing symptoms of an ulcer or acid reflux.

Additionally, a large number of other stomach and intestinal disorders can lead to symptoms of burning, nausea and vomiting. When vomiting, a person might also regurgitate bits of food or feel as though food is stuck in the upper chest. Other symptoms possibly linked to reflux include difficulty swallowing and excessive salivation. Blood in the vomit indicates potentially serious esophageal or stomach damage. When a person with reflux has symptoms like these – trouble/painful swallowing, recurrent vomiting, or bleeding – these are all signs that a closer look might be needed, and indications for upper endoscopy imaging studies.


Chronic or persistent symptoms are a sign of gastroesophageal reflux disease (GERD), which can eventually cause long-term injury. The esophagus can become scarred together at points, called strictures, or the tissue lining the esophagus can start to become pre-cancerous (Barrett’s esophagus).

As the acid reflux affects other areas, complications in the respiratory system, throat and mouth may develop. Chronic cough, hoarseness, asthma, dental problems, damaged teeth, and sinus problems may be indicative of reflux, in addition to the damage to the esophagus.

Symptoms may worsen or improve at night. With supine acid reflux, symptoms become worse when a person is lying down and sleeping. With upright acid reflux, symptoms begin when a person is upright and conscious.

In one recent study, people who had damage – erosive esophageal reflux disease –had more frequent episodes of reflux, longer lasting episodes, and more episodes happening at night when lying down, as compared to the people who had reflux but no erosive damage.

Because you are asleep, you may not notice that you are experiencing heartburn. Other people experience heartburn that is so painful that it is difficult to sleep through the night. Many people with persistent heartburn are unable to get a full night's rest.

Certain foods may trigger the onset of symptoms. These include greasy foods, meats that are high in fat, butter, mayonnaise, cream-based sauce, salad dressing, chocolate, dairy products, and beverages with caffeine. Citrus and acidic foods can also trigger symptoms.

Warning Signs

Sometimes, a heart attack feels like heartburn. If you or someone in your care is having heart attack symptoms, get medical help immediately by dialing 911.

Barrett's esophagus is a condition that results from acid reflux over the longer term. The normal esophageal lining becomes damaged and replaced with a lining that is typical in the intestines. Those with Barrett's esophagus are 30 times more likely to develop a type of esophageal cancer known as esophageal adenocarcinoma. Warning signs include weight loss, pain while eating, problems swallowing, and blood in the vomit.

According to the American Gastroenterological Association, people with multiple risk factors for this kind of cancer should be screened for Barrett’s esophagus. Risk factors include:

  • people age 50 or older,
  • male,
  • white,
  • chronic GERD,
  • hiatal hernia, and
  • overweight/obesity.

Take the Next Steps

Talk to your doctor about the heartburn symptoms. Frequent heartburn may require medication. If the symptoms are mild and occasional, lifestyle changes might be recommended. If you notice that certain fatty foods are causing your heartburn, then you should do your best to avoid them. If you notice that large portions are causing your acid reflux, then try to eat smaller meals throughout the day. Stress can also cause symptoms of heartburn, so try to maintain a balanced lifestyle.

Giving Care

The stress and lack of sleep that sometimes come with caregiving are not good for heartburn. If you are burning the candles at both ends, step back, listen to your body and look into your symptoms. Also, consider reaching out to others for help so that you can get a good night sleep, or to allow for a bit more time for yourself.

Caring for someone with heartburn and a heart condition can be especially nerve-wracking. It might help your confidence at home to have a good, long talk with your doctor about cardiac warning signs and alert symptoms, specifically with your loved one in mind. Doing so can boost your ability to give reassurance when appropriate.

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