Gastroesophageal reflux disease (GERD) is the most common condition that affects the upper part of the gut. Most of us simply know it as acid reflux or by the main symptom – heartburn. But there is much more to the condition than just heartburn. Sometimes gastroesophageal reflux disease does not even present with heartburn. A person may have almost none of the typical signs and symptoms of acid reflux but could be suffering with the condition to a severe degree.
So how do you know if you are suffering with acid reflux? Despite being the most common upper GI condition, many cases remain undiagnosed. Acid reflux is a condition where stomach acid passes into the esophagus (food pipe) when the lower esophageal sphincter (LES) fails to prevent this backward movement of the stomach contents.
Apart from heartburn, most of us know that acid reflux also causes a type of discomfort and bloating that we refer to as indigestion, nausea and a loss of appetite. But there are other symptoms that are less known yet equally important in assessing gastroesophageal reflux disease (GERD). Some of these symptoms can be very serious and affect a person for the long term even after the reflux subsides. For those GERD sufferers without the typical symptoms or suffering with silent acid reflux, spotting these unusual symptoms can help in the diagnosis and proper treatment of GERD.
Water brash is one of the common symptoms yet it is not as well known as the other symptoms of acid reflux. Remember that the acids can be neutralized by alkalis. Human saliva is alkaline and in order to try to neutralize the acid in the esophagus, the salivary glands produce massive amounts of saliva.
It is this excess salivation that is known as water brash. Even without experiencing heartburn, the presence of acid in the esophagus may signal the salivary glands to take action. Saliva fills in the mouth and when swallowed it can then neutralize the acid in the esophagus. Some people will even hear a gurgling in the mouth and back of the throat as large amounts of saliva is secreted.
Gastric acid has a bitter taste. Some people may describe it as sour as these tastes are confused at times. It is only when the stomach acid reaches the as high as the throat and mouth that it can be tasted. People with silent acid reflux may suddenly experience a bitter taste in the mouth without any of the other symptoms.
But for most, it is prominent when lying down and upon waking in the morning. By lying flat the stomach acid can reach higher up since it is not pulled down by gravity. A person may awake in the morning with a bitter taste in the mouth and not recall any other symptoms that may have been present during the course of the night.
Apart from the stomach and duodenum (first part of the small intestine), the rest of the gastrointestinal tract is unable to deal with the stomach acid. Given its corrosive nature, the acid can irritate and damage tissue which is not able to withstand it. The throat is one such area. Severe acid reflux and reflux when sleeping means that the stomach acid can reach as high as the throat.
While a person may cough or swallow when awake to clear the throat, take action to reduce the reflux or water brash neutralizes some of the acid, these mechanisms are not as effective when a person is asleep. A morning sore throat is one of the characteristic symptoms of acid reflux at night. The sore throat is typically worse in the morning upon waking and gradually eases during the course of the day only to recur by the next morning.
Nasal And Sinus Problems
It is not only the throat that can be affected by the presence of stomach acid. It can even reach as high as the nose. The stomach acid may inflame and damage the nasal lining, often involving the paranasal sinuses as well. However, most of the time nasal and sinus problems are not attributed to acid reflux as allergies and infections are more common causes.
The nasal mucosa, which continues into the paranasal sinuses, is responsible for mucus production as well as a host of other functions such as warming the inhaled air. When it is damaged by stomach acid these functions are then affected. Nasal and sinus congestion, burning in the nose, alterations in the sense of smell and repeated nasal and/or sinus infections are some of the common symptoms as a result of acid exposure.
The airways also has its own mechanisms to prevent potentially harmful substances from reaching the lungs. Apart from the tiny hairs lining the airways and the mucus it secretes to trap dust and microbes, coughing can push out any substance that enters the respiratory passage. But this is not always sufficient to keep the lungs safe from microbes and noxious substances. Stomach acid can irritate and damage the airways and even reach the lungs. It is more likely to occur at night while sleeping when the respiratory defense mechanisms are suppressed.
Studies have revealed that acid reflux plays an important role in many acute and chronic respiratory problems, including childhood asthma. Aspiration pneumonia is am inflammatory condition of the terminal airways and lungs that may be caused by a host of foreign substances, including stomach acid. It can occur during vomiting but studies have revealed that as many as 20% of people suffering with chronic GERD may develop aspiration pneumonia.
Do you have reflux?
Most cases of acid reflux are diagnosed by the symptoms reported. It is further confirmed if the proper use of antacids and acid-suppressing drugs, along with lifestyle measures to prevent reflux, show an improvement in these unusual symptoms. However, there are a number of diagnostic investigations that your doctor can conduct to confirm acid reflux even if you do not have the typical symptoms.
If you suspect that you do have acid reflux then it is advisable to seek professional medical assistance before you start using antacids or other acid-suppressing drugs, even over-the-counter medication that is deemed safe. By attempting to treat undiagnosed acid reflux on your own, other more serious conditions may be missed and long term management may not be as effective without professional medical supervision.