Not all of them are obvious.
By Stella Katsipoutis
Feel like you just can’t keep that nasty stuff in your belly from bubbling up into your throat? What you’re experiencing might not be run-of-the-mill heartburn. It could be a case of gastroesophageal reflux disease—GERD, for short—a condition that causes the acid and food in your stomach to rise into your esophagus, and sometimes even enter your mouth or lungs. GERD is far from rare: In fact, it occurs in 20 percent of the U.S. population, according to the medical journal Gastroenterology. But there are also several factors that make some people an easier target for the disease.
“Everyone has a small, normal amount of gastroesophageal reflux, but an abnormal amount of acid reflux occurs when the one-way valve between the esophagus and the stomach, called the lower esophageal sphincter, becomes too loose,” says Ketan Shah, M.D., gastroenterologist at Saddleback Medical Center in Laguna Hills, California. “This can occur for multiple reasons that cause intra-abdominal pressure to be abnormally elevated, including being overweight or obese, frequent overeating, lying down too soon after eating, chronic straining or coughing, or chronic heavy lifting. These are typically the people who are more susceptible to GERD.”
Surprisingly, as common as GERD is, diagnosing it isn’t always a piece of (regurgitated) cake. Different people can experience different warning signs—some of which you wouldn’t typically think are pointing to gastroesophageal reflux. Leaving the disease undiagnosed and untreated could set you up for not only major chronic discomfort in the short term, but also for bigger issues down the road: “It can predispose the esophagus to changes that can eventually lead to cancer,” says Jennifer Katz, M.D., attending gastroenterology physician and assistant professor of medicine at Montefiore Medical Center. So if you’ve picked up on any of these five signals from your body lately, then GERD might be the word—and you should get to a doctor pronto.
Heartburn won't go away
This one’s easy to spot because it is exactly what it says it is: a burning sensation in your chest. But because heartburn is a condition all of its own, many people don’t play connect-the-dots and realize that persistent heartburn can also be a common symptom of something more serious. “Occasional heartburn and regurgitation is normal to a certain extent,” says Shah, “but when heartburn occurs on a regular basis, then it is likely GERD.” (Kick-start your new, healthy routine with Women's Health's 12-Week Total-Body Transformation!)
When GERD starts pumping food and bile out of your stomach and up your throat, the acidic contents can quite literally leave a bitter taste in your mouth. They also blaze what feels like a scorching-hot trail through your esophagus, leaving you with a sore, burning throat and causing your mouth to produce an excess amount of saliva in an effort to put out the flames.
And like any real fire, this particular symptom shouldn’t be taken lightly, says Shah: “This can sometimes result in more serious problems, including esophagitis (damage from acid eroding the lining of the esophagus), hiatal hernia (when the stomach slides up above the diaphragm and into the chest), esophageal ulcers, strictures (or esophageal narrowing from scar tissue), or Barrett’s esophagus (a precancerous condition and the most important risk factor for esophageal cancer).”
“Those who have complications from GERD may have trouble swallowing or feel that certain foods get stuck in their throat when trying to swallow,” says Lea Ann Chen, M.D., gastroenterologist and assistant professor of medicine at NYU Langone Health. This is also known as dysphagia, and it could lead to unhealthy weight loss if you consistently can’t bring yourself to eat thanks to the lump you feel in your throat.
“Many people find that particular foods trigger their symptoms—like chocolate, caffeine, spicy or acidic foods,” continues Chen. “If so, they should avoid these triggers. In addition, eating frequent small meals and spacing out the time (at least three to four hours) between your last meal or drink and laying down at night may also help.”
Heart Attack Feeling
This is where some detective work might start coming into play. “Because the heart is also located in the chest, where GERD occurs, sometimes GERD symptoms are commonly mistaken for cardiac symptoms. Similarly, sometimes cardiac pain—like a heart attack—can be mistaken for GERD,” says Toyia James-Stevenson, M.D., a gastroenterologist at Indiana University Health. If you’re not sure whether your chest pain is the byproduct of heart troubles or GERD, Katz says your safest bet is to talk to your doc right away to rule out any life-threatening cardiac conditions before you start worrying about GERD.
As stomach acid inches up your food pipe, there’s a possibility that some of it can sneak into your lungs too, causing respiratory issues ranging from no big deal (like persistent coughing, chest congestion, and hoarseness) to totally unexpected (like asthma, laryngitis, pneumonia, or wheezing). “The problem is that GERD is not the most common cause of these atypical symptoms, so patients often go through a variety of tests and treatments before their doctors are able to determine that GERD is the cause,” says Shah.
If you experience recurring acid reflux and a sudden onset of a respiratory issue like asthma, give your doctor a heads-up so they can determine if GERD is the culprit behind your breathing troubles. For the less-intense side effects, like coughing and hoarseness, which can get worse at nighttime, Katz recommends keeping your head elevated when you go to bed and avoiding meals three to four hours before bedtime to help minimize discomfort.
While figuring out if you have GERD could feel like a guessing game at times, the good news is that you’ll have plenty of options for symptom relief and treatment if you’re diagnosed. “There are several over-the-counter medications that can help with GERD, but often altering when and what you eat can dramatically improve symptoms,” says James-Stevenson. “Many primary care physicians treat GERD, so talking with your family physician or gastroenterologist about your symptoms is a great first step.”