Symptoms

Heartburn symptoms usually occur after overeating or lying down after a big meal. The symptoms may last for a few minutes or a few hours.

The severity of symptoms depends on the:

• Reason the muscle is weakened
• Amount of acid entering the esophagus
• Amount of saliva to neutralize the acid

Symptoms include:

• Burning feeling that starts in the lower chest and moves up the throat
• Feeling that food is coming back up
• Sour or bitter taste in the throat
• Pain that increases when bending over, lying down, exercising, or lifting heavy objects

Other symptoms and complications of reflux include:

• Sore throat
• Hoarseness
• Chronic cough
• Feeling of a lump in the throat
• Asthma
• Hoarse voice ( laryngitis )
• Waking up with a sensation of choking

If reflux persists, the acid can damage the esophagus. Symptoms of esophageal damage include:

• Bleeding and ulcers in the esophagus
• Difficulty swallowing
• Vomiting blood
• Black or tarry stools
• Inflammation and scarring of the esophagus
• Barrett's esophagus —This is a precancerous condition of the esophagus that has no unique symptoms, but can be diagnosed by endoscopic exams.
• Dental problems (due to the effect of the stomach acid on the tooth's enamel)

Diagnosis

Heartburn can feel like heart attack pain. If you feel this pain, call 911 right away.

The doctor will ask about your symptoms and medical history, and perform a physical exam. Tests may include:

• Upper GI series —a series of x-rays of the upper digestive system taken after drinking a barium solution
• 24-hour pH monitoring—a probe placed in the esophagus tracks of the level of acidity in the lower esophagus
• Manometry—a test that measures muscle pressure in the lower esophagus
• Endoscopy —a thin, lighted tube is passed down the throat to look at the esophagus and stomach, a tissue sample may be taken
• Biopsy —a small sample of esophageal tissue is removed to measure the amount of acid or pressure in the esophagus

Upper GI Biopsy

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