Disease Symptoms

Acid reflux disease, or more correctly, gastroesophageal reflux disease is the result of the failure of the body's normal antireflux mechanism to protect against the effortless movement of the gastric content from the stomach to the upper pars of the digestive tract (esophagus). Gastroesophageal reflux is a normal physiological process, with no signs, symptoms or consequent mucosal damage but in gastroesophageal reflux disease symptoms of heartburn and acid regurgitation occur.

The signs and symptoms of gastroesophageal reflux disease may be esophageal (heartburn , acid reflux, odynofagia) or extraesophageal.

The classical symptom for this disorder is heartburn.

The patients usually complain of a burning heeling rising from the stomach or epigastric area toward the neck and throat. This symptom usually manifests or exacebates postprandially, especially if the patient has eaten spicy foods, fats, chocolate or drank alcohol. Heartburn may also be exacerbated by bending over or recumbency, and , if it occurs at night it will interfere with sleeping. Inspite of the fact that this symptom is an important diagnostic clue, its intensity, frequency and duration is not a parameter in order to evaluate the severity and the degree of mucosal damage.

Another common symptom of gastroesophageal reflux disease is acid regurgitation. The postprandial effortless regurgitation of acid fluid, especially if exacerbated by recumbency is a very suggestive feature of gastroesophageal reflux disease. Most patients presenting with this symptom have a associated gastroparesis and a reduced LES (lower esophageal sphincter) pressure. In time, most of the patients will also develop esophagitis.

More than 40% of the patients complain of dysphagia which begins as a longstanding heartburn progressing slowly towards a dysphagia for solid foods. Still, most of them have a normal appetite and so weight loss occurs only rarely (in about 5% of the patients, most of them with severe esophagitis).

Waterbrash is a less common symptom of the disease and it consists in the spontaneous, sudden apparition of a salty or sour fluid which is caused by the salivary glands's  response to the disease.

Odynophagia or pain in swallowing may occur after the development of ulcerative esophagitis but it may be caused by a variety of other disorders, most of them with an infectious etiology. It is highly important that the underlying cause of odynophagia be sought.Other less common symptoms of gastroesophageal reflux disease are nausea,  hiccups, burping and vomiting.

The extraesophageal manifestations of the disease are: noncardial chest pain mimicking angina pectoris and which usually worsens after meals, chronic cough, asthma (there have been studies suggesting that gastroesophageal disease may have an impact on triggering and/or aggravating asthma),  posterior laringitis, vocal cord ulcers and granulomas, and dental erosion.