Heartburn, as its name implies, is a burning sensation that is centered over the area of the heart. However, it has nothing to do with heart problems. This is the same area occupied by the esophagus and this is roughly where heartburn occurs. It is usually worse after eating, especially when lying down. Occasional heartburn can be treated without a doctor's advice by simple over-the-counter remedies, but more long term heartburn should be investigated by a doctor.

Severe heartburn is associated with acid reflux and it is often the presenting complaint. It is vital that a physician ensure that any severe chest pains are caused by acid reflux rather than by heart problems such as angina or infarction. In cases of reflux disease, severe chest pain most often occurs at night, due to postural changes as noted above.

The second most common symptom is dyspepsia, a chronic or recurrent pain centered in the upper abdomen. As with other acid reflux symptoms, the extent or expression of dyspepsia is varied and does not indicate the extent of damage to the esophagus. This pain may be accompanied by nausea and vomiting, or may express itself as only a sensation of fullness in the stomach. Again, dyspepsia may be present without reflux.

The next most common of the acid reflux symptoms is regurgitation, a sudden feeling of the stomach contents flowing back up the esophagus into the throat or mouth. In severe cases, the contents may actually be burped or even vomited. Regurgitation may or may not be associated with nausea. Occasional regurgitation occurs, especially in children, and by itself does not indicate reflux disease.

Many other symptoms of acid reflux disease exist, however they are less common. These may include a rough unproductive cough, hoarseness, gasping for breath or laryngitis. Less common are chronic sore throat, a "lump-in-the-throat" feeling, sinusitis or chronic hiccups. A very rare symptom, not linked to any of the other symptoms, is chronic nausea, possibly lasting for months intermittently.

Fortunately, most primary care physicians can easily diagnose acid reflux disease, but sometimes complicated situations can make the doctor unsure. In this case, a diagnosis can usually be reached by using a trial dosage of medication that will temporarily prevent the stomach from secreting acid. It is important to rule out all other conditions that might be suggested by the many symptoms of reflux before definitively diagnosing reflux disease.