Over the years I have seen very many patients with acid reflux. Acid reflux symptoms are wide and varied. The traditional ones of course are heartburn and regurgitation of food. This may lead to a bitter taste in the mouth which is called waterbrash. These symptoms classically occur when people have just eaten, when they do exercise or lean forward. But there are quite a few less common acid reflux symptoms. Read on to find out more…
Less common symptoms of acid reflux
Less common symptoms include
- chest pain which can be severe or crushing just like angina. This is often the first time someone discovers that they have gastroesophageal reflux disease (GERD or GORD)
- abdominal pain or discomfort
- difficulty swallowing or food sticking in the chest
And now for some really odd symptoms:
A patient came to see me who had a tickly cough. This always occured after eating. He had no other symptoms at all. Endoscopy showed no abnormalities but a Bravo 24-hour pH study demonstrated severe acid reflux. Treatment with a proton pump inhibitor completely abolished the symptoms. When he stopped the medication the symptoms returned and disappeared again when he restarted it.
But last week I saw a young man who complained of funny noises in his stomach. But only occurred after eating and were so troublesome that they interfered with his ability to socialise. Once again endoscopy was normal but a Bravo ambulatory pH study performed at the time of endoscopy showed severe acid reflux both day and night. Night-time acid reflux is relatively uncommon but people who suffer with it often get very odd symptoms in my experience. He is certainly one of those. He was so delighted when I managed to find a cause for his problems which had been troubling him for a long time and which other specialists had not been able to diagnose.
So how do I treat these patients? They don’t have heartburn and they don’t really have classical indigestion either. You could say that the first patient had laryngopharyngeal reflux. But usually patients with LPR demonstrate a sore throat or hoarse voice. A cough by itself is really very non-specific. As for the noises in the stomach which are called borborygmi in the trade, most people would never even think of acid reflux amongst the causes. But it turns out that it is one of the symptoms of acid and a good specialist needs to think of this!
Luckily the treatments are pretty straightforward for most patients. Proton pump inhibitors work very well for almost three quarters of patients. For the rest there are a series of other treatments. These range from dietary changes to visceral hypersensitivity reducing agents to acupuncture. More on that in another blog post.
Just because you have strange symptoms does not mean that they are not related to acid reflux. A good doctor needs to carefully evaluate the symptoms and do the correct investigations before offering the right treatments!