Symptoms of Heartburn
The symptoms of heartburn are usually easy to recognise, but they can sometimes be mistaken for other conditions. Especially cardiac or upper abdominal disorders. Typically, heartburn presents as a burning sensation behind the breastbone that rises toward the throat. However, this classic symptom can manifest in various ways depending on the person’s age, diet, underlying health, and lifestyle. Understanding the full spectrum of the symptoms of heartburn helps ensure early intervention. Furthermore, avoid misdiagnosis or complications such as gastro-oesophageal reflux disease (GORD).
The hallmark symptom is a burning pain in the chest, most often located just behind the sternum. This discomfort may start low in the chest or upper abdomen and gradually rise toward the throat. The sensation is often described as hot, acidic, or sharp, and is usually most noticeable after meals—especially when lying down, bending over, or exercising. For many people, the pain becomes worse in the evening or at night when the effect of gravity is reduced, allowing acid to move more easily into the oesophagus.
Another common symptom is regurgitation, where acid or partially digested food flows back into the throat or mouth. This can produce a sour or bitter taste and may be accompanied by a sensation of liquid or gas rising from the stomach. Unlike vomiting, regurgitation is passive and not accompanied by nausea. In chronic cases, regurgitation may lead to dental erosion, chronic bad breath, or a sore throat.
Some individuals report difficulty swallowing (dysphagia) or the feeling of food getting stuck in the throat or chest. This can occur if frequent acid exposure causes inflammation or narrowing of the oesophagus (stricture formation). Although this is more common in advanced or long-standing cases, even mild heartburn can temporarily interfere with the sensation of smooth swallowing.
Symptoms of Heartburn
Throat symptoms are another frequent but often overlooked manifestation. These include a persistent sore throat, hoarseness, or the feeling of a lump in the throat (globus sensation). These symptoms are more likely to occur in cases where stomach acid travels far enough up the oesophagus to reach the larynx and vocal cords—a condition referred to as laryngopharyngeal reflux (LPR). While traditional heartburn involves chest pain, LPR may present almost entirely with throat discomfort.
Chronic cough is a lesser-known but significant symptom. When acid irritates the throat or airways, it can cause a dry, hacking cough that doesn’t improve with standard cold or allergy treatments. The cough is often worse at night or after eating and may be accompanied by wheezing or shortness of breath, which can resemble asthma. For this reason, many people with “silent” reflux are misdiagnosed until further testing is done.
Another possible symptom is chest pressure or tightness. While often attributed to cardiac causes, heartburn can mimic the pain of angina. The pain is typically located in the centre of the chest and may radiate to the neck, throat, or jaw. Unlike cardiac pain, heartburn is often triggered by food, posture, or physical activity and may improve with antacids. However, distinguishing between the two is not always easy, and anyone experiencing chest pain should seek medical advice to rule out a heart attack or other serious conditions.
Bloating and burping can also occur alongside the burning sensation. These symptoms arise when excess gas builds up in the stomach due to delayed digestion, carbonated beverages, or swallowed air. Although not specific to reflux, they frequently accompany heartburn and can worsen the sensation by increasing intra-abdominal pressure.
Symptoms of Heartburn
Some patients experience nausea, particularly after eating large or rich meals. Nausea in the context of heartburn does not usually lead to vomiting but may be persistent and cause loss of appetite or aversion to food. In rare cases, reflux-induced nausea may be confused with morning sickness during pregnancy or mistaken for food poisoning or gastrointestinal infections.
In children, the symptoms of heartburn may not be as clear-cut. Infants and toddlers may exhibit feeding difficulties, irritability during or after meals, arching of the back, and frequent spitting up. Older children may complain of tummy aches, throat discomfort, or a sour taste in the mouth. Because children are often unable to articulate what they feel, persistent symptoms should prompt medical evaluation to rule out GORD or other digestive issues.
During Pregnancy
During pregnancy, the symptoms of heartburn tend to increase due to hormonal changes that relax the lower oesophageal sphincter and mechanical pressure from the growing uterus. Pregnant individuals may experience more frequent and intense episodes of burning, especially in the third trimester. Although usually temporary, heartburn during pregnancy can cause significant discomfort and disrupt sleep.
Symptoms of heartburn can vary in frequency and severity. Some individuals may have daily discomfort that interferes with work or sleep, while others only notice symptoms after particularly large or indulgent meals. Importantly, the severity of symptoms does not always correlate with the degree of damage in the oesophagus. For instance, some people with significant inflammation (oesophagitis) may experience only mild symptoms, while others with normal endoscopy findings may report intense discomfort.
When heartburn lasts a long time and is not well controlled, it can cause problems like erosive oesophagitis, Barrett’s oesophagus, or peptic strictures. These conditions can make it hard to eat, speak, and enjoy daily life. Because of this, doctors say you should never ignore ongoing or worsening symptoms. Instead, get help early to avoid these complications.
Symptoms of Heartburn
In summary, the symptoms of heartburn extend far beyond the classic burning in the chest. They may include regurgitation, throat irritation, cough, bloating, and even symptoms that mimic other diseases. Recognising these diverse signs allows for timely diagnosis and treatment, preventing complications and improving patient comfort. While occasional heartburn is common, persistent symptoms warrant professional evaluation.
