Skip to main content

What are the symptoms of reflux?

By 25th January 2025Health Conditions
Acid Reflux

Acid reflux is a common digestive complaint that impact the upper part of the digestive tract.

This condition impacts around 20% of those in Western cultures and leads to a wide range of symptoms as well as possible complications. This article will explore these common and less common symptoms of reflux. [1]

What is acid reflux?

Acid reflux occurs when the acid that is produced in the stomach travels upwards into the oesophagus and throat. This can lead to irritation, which is behind most of the common complaints of this condition.

Acid reflux can occur periodically in certain situations. However, if it continues or is experienced regularly this may be where the diagnosis of GERD is given. [2]

Who gets acid reflux?

This condition is considered to be multi-faceted. This means that a wide range of risk factors can contribute to its onset.

Some of these risks are physiological, meaning a change or alteration in the physical structure of the digestive tract or related to lifestyle or diet.

Physiological factors include:

· increased compliance of the oesophagus-gastric junction

· higher pressure gradient across the oesophagus-gastric junction

· weakness of the lower oesophageal sphincter (LOS)

Lifestyle factors include:

· smoking

· stress

· dietary factors (coffee and spicy foods)

· obesity

· inactivity

· alcohol intake

Other factors include:

· family history of reflux · genetics [3]

Common symptoms of acid reflux

A range of symptoms are considered to be the most common associated with acid reflux.

For many sufferers of acid reflux, these can be present to some degree. However, their severity can fluctuate between patients.

Heartburn

Heartburn can often be used as another way to describe reflux. While reflux can describe the upward movement of acid from the stomach into the throat or mouth, heartburn specifically describes pain or a burning sensation behind the breastbone, in the chest or upper abdomen. This may be worse after eating, or when bending over or lying down. [4]

Regurgitation

Regurgitation is the upward movement of stomach contents into the throat or the mouth. This is different to vomiting or nausea but can involve the contraction of certain muscles in the digestive tract.

This can contain food, but it is often very acidic and can lead to a burning sensation in the throat or mouth before the regurgitated substance is swallowed again.

Chest pain

Chest pain is a common symptom of reflux which can commonly be confused with cardiac pain. While heartburn is usually being the breastbone, it can also spread to the neck. Cardiac chest pain may be similar but it can also spread to the jaw, neck, back as well as arms.

Burping (or belching)

Burping (or belching) can be triggered by excess gas in the stomach or small intestine. This may be due to swallowed air or an increased production of gas in the gut, possibly related to bloating.

This upward movement of gas can bring with it acid substances from the stomach (acid or pepsin), which can trigger reflux symptoms and irritation.

Swallowing Difficulties (Dysphagia)

Swallowing difficulties can be the result of inflammation in the throat. This inflammation can be triggered but the acid coming into contact with the lining of the upper GI tract.

This inflammatory response may then inhibit the appropriate contraction of muscles in the throat, leading to swallowing difficulties. This can lead to the sensation of food becoming stuck soon after it is swallowed. [5]

Throat Clearing and Mucus

Throat clearing and mucus may be triggered by irritation in the throat or oesophagus. This is due to irritation to the gut lining, leading to an increase in the protective mucus along the lining of the gut. This can help to protect the lining from any harm and further irritation.

Dyspepsia

Dyspepsia typically describes a wider range of symptoms that are often terms indigestion. This can include sensations of heartburn and reflux but also feeling overly full after eating along with pain and discomfort in the upper part of the abdomen.

Less common symptoms of acid reflux

There are further symptoms of acid reflux that may be less common than those listed in the section above. However, it’s not unusual for these to be present also. Their frequency and severity can also be quite unpredictable.

Weight Loss

Weight loss can be a knock-on effect of some of the common symptoms of reflux. Digestive pain, difficulty swallowing and heartburn may all make it less appealing to eat, resulting in reduced calorie intake and weight loss.

Ear Pain

Ear pain may result from acid making its way into the throat and then the tube that connects to the ear. This may increase pressure in the ear as well as a low-level irritation. Both factors may cause ear discomfort, which can be experienced as pain, irritation or itching in the ear. [6]

Post-Nasal Drip

Post-nasal drip is the sensation of liquid, mucus or snot running down the back of the throat. This can be similar in cause to the symptoms of mucus in the throat.

Voice Problems (Dysphonia)

Voice problems can be the result of irritation to the throat and vocal cords. This is via the acid coming into contact with this region and leading to an inflammatory response. This may be worse first thing in the morning or after a long day of using the voice. [7]

Shortness of Breath and Respiratory Issues

Shortness of breath and respiratory issues can be a symptom of GERD and reflux due to acid making its way into the lungs. This may be common when there the acid moves upwards into the throat but then downwards into the lungs leading to irritation.

When to seek medical advice

Untreated reflux may lead to more serious issues, so it’s important that it is assessed and treated. Often, the best time to seek medical advice is before symptoms become chronic. Particular warning signs should, however, be considered trouble swallowing, difficulty breathing, and weight loss.

If symptoms are ongoing, further assessments and treatments should be considered.

Conclusion

A wide range of digestive and non-digestive symptoms can be related to reflux. This means that appropriate assessments and treatments are often appropriate to understand and address the underlying causes of the condition.

While certain medications may work to reduce or suppress symptoms, working with a registered gut health practitioner can help you understand the actual cause of symptoms and restore balance to your gut.

References

· Antunes C, Aleem A, Curtis SA. Gastroesophageal Reflux Disease. [Updated 2023 Jul 3]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441938/ · https://www.nhs.uk/conditions/heartburn-and-acid-reflux/

· Sadafi S, Azizi A, Pasdar Y, Shakiba E, Darbandi M. Risk factors for gastroesophageal reflux disease: a population-based study. BMC Gastroenterol. 2024 Feb 5;24(1):64. doi: 10.1186/s12876-024-03143-9. PMID: 38317085; PMCID: PMC10840240.

· Kellerman R, Kintanar T. Gastroesophageal Reflux Disease. Prim Care. 2017 Dec;44(4):561-573. doi: 10.1016/j.pop.2017.07.001. Epub 2017 Oct 5. PMID: 29132520.

· Oda K, Iwakiri R, Hara M, Watanabe K, Danjo A, Shimoda R, Kikkawa A, Ootani A, Sakata H, Tsunada S, Fujimoto K. Dysphagia associated with gastroesophageal reflux disease is improved by proton pump inhibitor. Dig Dis Sci. 2005 Oct;50(10):1921-6. doi: 10.1007/s10620-005-2962-5. PMID: 16187198.

· Poelmans J, Tack J, Feenstra L. Chronic middle ear disease and gastroesophageal reflux disease: a causal relation? Otol Neurotol. 2001 Jul;22(4):447-50. doi: 10.1097/00129492-200107000-00005. PMID: 11449097.

· Cesari U, Galli J, Ricciardiello F, Cavaliere M, Galli V. Dysphonia and laryngopharyngeal reflux. Acta Otorhinolaryngol Ital. 2004 Feb;24(1):13-9. PMID: 15270428.

History

Uploaded by Martin Cohen 24/01/2025