One of the problems with chronic heartburn or GERD (gastroesophageal reflux disease) is that you may not know you have it. Many people aren't completely woken up by GERD symptoms at night. In some cases of GERD, there may be no symptoms at all, even when you're awake. However, there are a number of things you should look for.
Waking up to a bitter, acidic taste in your mouth
Sharp, burning pain in your chest that can extend up to your neck and throat
Fatigue during the day
Chronic cough or fits of coughing that wake you up in the night
Sore throat, hoarseness, or asthma attacks
In some cases of GERD, the acid can rise so high in the esophagus that a person can actually breathe it in. This can lead to respiratory problems, such as cough or hoarseness.
Your description of your symptoms may be all a doctor requires to diagnose heartburn, but sometimes additional testing may be necessary. The esophagus can be viewed through an endoscope, a long, thin, flexible tube inserted through the mouth, or by X-ray.
Sometimes, your doctor may recommend a 24-hour esophageal pH probe study, especially if you have unusual symptoms, such as throat or chest or abdominal pain, coughing, or asthma-like symptoms. In this test, a long, narrow, flexible tube is inserted...
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There are other symptoms that experts call "warning signs." Any of them should be checked out right away.
Trouble swallowing or painful swallowing
Coughing up or vomiting blood
Blood in the stool
Unexplained weight loss
Keep in mind, the symptoms of heartburn are similar in some ways to the symptoms of heart trouble. If you're experiencing pain that feels different from your usual heartburn, get it checked out immediately. Pain after physical activity -- as opposed to after a spicy meal -- is also a worrisome sign. If you have even the slightest doubt about your chest pain, err on the side of caution. Treat it as a medical emergency and go to the nearest emergency room.
SOURCES: Lawrence J. Cheskin, MD, FACP, co-author of Healing Heartburn (2002); director and founder, Johns Hopkins Weight Management Center; and associate professor of international health and human nutrition; and associate professor of medicine, Johns Hopkins School of Medicine. Stuart Spechler, MD, spokesman, American Gastroenterological Association; and chief, division of gastroenterology, Dallas VA Medical Center; and professor of medicine, University of Texas Southwestern Medical Center at Dallas. David White, Easthampton, Mass. The American Gastroenterological Association web site. The National Heartburn alliance web site. The National Institute of Diabetes and Digestive and Kidney Disorders web site.