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Acid Reflux Symptoms

An acid reflux attack can be really unpleasant, particularly if you have never had one before. At its worst, it resembles a heart attack, with severe central chest pain which goes up into the shoulder. If this happens, you need to go to hospital to be checked. If it is less severe, it can still cause bad heartburn, chest pain, or nausea and even vomiting.

Chest Pain

Chest pain due to acid reflux attacks can be almost impossible to distinguish from a heart attack and if it is severe, it needs to be treated very seriously. Nevertheless, there are a few tell-tale signs that the problem is due to digestion.

  • First: have you just eaten a large or fatty meal? (more likely reflux)
  • Second: are you young and fit and can you usually do vigorous exercise? (more likely reflux)
  • Third: have you suffered with indigestion in the past? (more likely reflux)
  • Fourth: did the pain come on after exercise? (more likely heart)
  • Fifth: are you also breathless? (more likely heart)

You may need an ECG or blood tests to be able to distinguish chest pain due to reflux (also called ‘atypical chest pain’) from a heart attack. If this happens to you, please call your doctor urgently for advice.


This is the most typical symptom of an acid reflux attack. Heartburn is a burning sensation which starts in the pit of the stomach, just below the bottom of the breastbone, and rises through the chest. It is typically brought on by eating, particularly large or fatty meals. It may also be caused by exercise or bending forward.

Waterbrash and Choking

Waterbrash means bringing a bitter or acidic tasting fluid into the back of the mouth. Once again, this particularly happens after eating, exercising or bending forward. If it happens at night, the acidic fluid can go into the lungs. This causes a terrible feeling of choking which can last for a minute or two before subsiding. This choking feeling is never fatal but it is very unpleasant. Fortunately, there are good treatments to prevent this occurring. Indeed, this symptom is the one which tends to respond best to antireflux surgery.


Dysphagia means difficulty swallowing. There are many causes but if solid foods get stuck before reaching the stomach, this can be due to acid reflux. It can, however, be a sign of oesophageal cancer and so urgent referral to a specialist is recommended if this occurs.


An on-going intermittent cough can be due to acid reflux and can actually be the only sign a person has the condition. It is usually easily treated and responds well to medicines

Hoarse Voice

One of the really strange effects of an acid reflux attack is that it can cause a person to become hoarse. If the attack occurs in the middle of the night, the person may not even realise it has happened. Instead, they wake up with a hoarse voice which can last for a few days. If attacks occur frequently, a person can have a hoarse voice which never gets better. This needs proper investigation and specialised treatment to cure because acid reflux attacks which present in this way are very difficult to detect.


The commonest test needed to investigate suspected acid reflux is endoscopy. This looks for inflammation (oesophagitis) and other complications but it does not actually measure the amount of acid reflux itself. A better test for this, which may be done in addition, is 24 hour pH studies. This test is not the favourite test for many people and we are delighted that we can offer the BRAVO ambulatory pH study which can be done at the same time as the endoscopy. This allows for immediate assessment of the severity of acid reflux during the endoscopy without the need for further tests. Please look here for more details.