The main symptoms of gastroesophageal reflux disease (GERD) include:

• Persistent heartburn. Heartburn is an uncomfortable feeling or burning pain behind the breastbone. It may occur after eating, soon after lying down, or when bending forward. Nonprescription medicines that reduce or block acid may relieve the pain. These include antacids (for example, Tums), H2 blockers (for example, Pepcid), and proton pump inhibitors (for example, Prilosec OTC). Heartburn caused by GERD is usually felt within 2 hours after eating. If your heartburn lasts for several hours-for example, all night-you may have severe GERD.²
• A sour or bitter taste in the mouth. The backflow of stomach acid and juices into the esophagus may be severe enough to cause a sour or bitter taste in your mouth. This often occurs along with heartburn, but in some cases it may be your only symptom.

If these symptoms occur more than twice a week, you may have GERD. Many people have occasional heartburn or a sour taste in the mouth. These instances are not considered to be GERD.

Some people have GERD without heartburn. Other symptoms of GERD can include:

• Chest pain. This may be a dull, heavy discomfort that spreads across the chest. This chest pain may occur with heartburn and may be confused with the pain of a heart attack. For more information on chest pain and heart attack, see the topic Chest Pain.
• Hoarseness.
• Trouble swallowing. This is more common with advanced GERD.
• A feeling that you have something stuck in your throat.
• A cough.
• Having extra saliva (this is called water brash).
• Nausea.

There are many other conditions with symptoms similar to GERD, such as peptic ulcer disease or an infection of the esophagus.