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Heartburn, a burning sensation that radiates from the stomach to just behind the sternum or even to the throat, is the primary symptom of acid reflux disease. Heartburn is typically worse after a heavy meal and during postural changes, especially while lying on the back. Occasional heartburn is common and not necessarily indicative of reflux disease, unless other acid reflux symptoms are noted. 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. Dyspepsia is a chronic or recurring pain in the upper abdomen. This may be a sign of acid reflux, although other acid reflux symptoms should also be present in order to make a definitive diagnosis. Dyspepsia can exist by itself as well and does not necessarily represent esophageal damage. Dyspepsia may involve nausea or just a feeling of being "stuffed". Acid reflux symptoms include regurgitation. This is a sudden feeling that the stomach contents are backing up into the throat or esophagus and a very common symptom. The regurgitation can be associated with nausea, although not necessarily so. In the most severe cases, stomach contents are actually burped up or even vomited. Regurgitation does also normally happen on occasion, especially in small children. By itself it is not an indicator of acid reflux. There are many other less common symptoms of acid reflux disease. Typically, these involve a rough unproductive cough, wheezing, hoarseness or laryngitis. Less common symptoms are a constant feeling of having a lump in the throat or chronic sore throat, sinusitis, and persistent hiccups. Even more uncommon is chronic nausea that is not associated with any other of the reflux symptoms. This nausea may be intermittent persist for months. Usually a diagnosis of acid reflux disease can be made without difficulty by a primary care physician. However, the multitude of symptoms that manifest in acid reflux requires that all differential diagnosis should be ruled out before declaring a definitive diagnosis.
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