What are the atypical symptoms of gastroesophageal reflux disease (GERD)?

In addition to common heartburn, gastroesophageal reflux disease (GERD) can present with atypical symptoms that many may not associate with the digestive system. These symptoms include a dry cough, hoarseness, asthma-like symptoms, a sour taste or food sensation at the back of the mouth, and difficulty swallowing. These symptoms can occur even in the absence of heartburn, sometimes making the diagnosis of GERD more challenging [1].

Understanding Atypical Symptoms

Atypical symptoms of GERD occur when acidic stomach contents reflux into the esophagus, but rather than causing direct heartburn, they affect other areas such as the throat, vocal cords, and respiratory tract. For example, persistent throat irritation can lead to a dry cough or hoarseness. Acid reflux can also exacerbate asthma symptoms or cause asthma-like symptoms [1].

When to Consult a Doctor

If you experience any of these atypical symptoms frequently, meaning twice or more per week, or if they cause you significant discomfort, it is important to consult a doctor. Untreated GERD can lead to other health issues over time, such as esophagitis, tissue scarring, or changes in the lining of the esophagus (Barrett's esophagus) [1]. It is also essential to seek medical attention immediately if you experience chest pain accompanied by shortness of breath or pain in the jaw or arm, as these could be signs of a serious heart condition [1].

Diagnosing GERD

To diagnose GERD, a doctor will ask about your symptoms and medical history. They may recommend tests such as an upper gastrointestinal endoscopy, which uses a small camera to examine the lining of the esophagus and stomach. This procedure can help determine the cause of unexplained symptoms, such as persistent pain, heartburn, vomiting, or swallowing problems, and identify conditions like GERD [3]. Other tests may include esophageal pH monitoring to determine how often acid reflux occurs and how long it remains in the esophagus [1].

Treatment Options and Next Steps

Most people can manage GERD through lifestyle changes and medications. Lifestyle changes include eating smaller meals, avoiding lying down after eating for at least 2-3 hours, avoiding trigger foods, elevating the head of the bed while sleeping, and quitting smoking [1]. Medications can include over-the-counter antacids or prescription drugs. In rare cases, surgery may be necessary if symptoms do not improve with medication or if there are more serious esophageal problems [2]. For more information on when heartburn becomes a disease, you can visit Gastroesophageal Reflux Disease (GERD): When does heartburn become a disease? (Arabic).

Medical references

• GERD
• Anti-reflux surgery
• Upper GI Endoscopy - NIDDK