Gastroesophageal Reflux Disease (GERD), commonly known as acid reflux, occurs when stomach acid frequently flows back into the esophagus. This backward flow can cause a burning sensation in the chest, often called heartburn. While many experience occasional acid reflux, persistent symptoms may indicate a more serious underlying condition. This article explores several conditions that can mimic acid reflux symptoms.
Esophageal Conditions
Conditions directly affecting the esophagus can produce symptoms similar to acid reflux.
Esophageal spasms involve uncoordinated muscle contractions in the esophagus, leading to sudden, intense chest pain that may be mistaken for heartburn or even a heart attack. These spasms can also cause difficulty swallowing and the sensation of food getting stuck or regurgitating.
Eosinophilic esophagitis (EoE) is a chronic immune system disease where white blood cells called eosinophils build up in the esophagus, causing inflammation. This inflammation can lead to symptoms such as chest pain, difficulty swallowing, and heartburn. Unlike GERD, EoE is often related to food or environmental allergens.
Achalasia occurs when the lower esophageal sphincter, the muscle valve between the esophagus and stomach, fails to relax properly. This prevents food and liquids from entering the stomach, causing symptoms like difficulty swallowing, regurgitation, chest pain, and heartburn. Achalasia symptoms tend to worsen gradually over time and can lead to malnutrition and weight loss.
Heart-Related Issues
Chest pain is a common symptom for both acid reflux and serious cardiac conditions.
Angina, a type of chest pain caused by reduced blood flow to the heart, can feel like pressure or squeezing in the chest, sometimes mistaken for indigestion or heartburn. This pain may radiate to the shoulders, arms, neck, or jaw and often worsens with physical exertion, improving with rest.
A heart attack, which occurs when blood flow to a part of the heart is blocked, also presents with chest discomfort described as pressure, tightness, or squeezing. Unlike heartburn, which might improve with antacids, heart attack pain usually persists and can be accompanied by shortness of breath, cold sweats, dizziness, and nausea. These symptoms may spread to one or both arms, the back, neck, or jaw.
Any sudden, severe, or unfamiliar chest pain, especially if it radiates to an arm or jaw, or is accompanied by shortness of breath, dizziness, or sweating, warrants immediate medical attention due to the serious nature of cardiac events.
Stomach and Abdominal Disorders
Several conditions originating in the stomach or other abdominal organs can produce symptoms similar to acid reflux.
Gastritis, an inflammation of the stomach lining, can cause upper abdominal pain, nausea, bloating, and a feeling of fullness after eating. While both gastritis and acid reflux can cause a burning sensation, gastritis pain is typically in the upper central abdomen and may be triggered by irritating substances like alcohol or certain medications.
Peptic ulcers are open sores that develop on the lining of the stomach or the upper part of the small intestine. They can cause a burning or gnawing pain in the upper abdomen, which may be mistaken for heartburn. Ulcer pain often occurs between meals or on an empty stomach and can sometimes be relieved by eating, whereas acid reflux pain usually appears after eating.
Functional dyspepsia is a chronic condition characterized by symptoms such as upper abdominal pain, burning, bloating, and early fullness after eating, without any identifiable structural cause.
Gallbladder issues, such as gallstones, can also mimic acid reflux symptoms. Gallbladder pain is typically concentrated in the upper right abdomen and may radiate to the back or right shoulder. This pain often occurs after consuming fatty meals and can be accompanied by nausea and vomiting, distinguishing it from the more central chest discomfort of acid reflux.
Other Mimicking Conditions
A range of other conditions from different body systems can also produce symptoms that might be confused with acid reflux.
Anxiety or panic attacks can manifest with physical symptoms such as chest pain, tightness, shortness of breath, a pounding heart, and a choking sensation. These symptoms can be intense and may lead individuals to believe they are experiencing a heart attack or severe heartburn.
Musculoskeletal pain, such as costochondritis, involves inflammation of the cartilage connecting the ribs to the breastbone. This condition causes sharp pain along the breastbone or sternum, which can worsen with deep breaths or coughing and may radiate to the arms or shoulder. The pain from costochondritis is localized and can be reproduced by pressing on the affected area, unlike acid reflux.
Certain lung conditions can also cause chest discomfort that might be misinterpreted. Asthma, a condition where airways narrow and swell, can lead to chest tightness, wheezing, and coughing. Pleurisy, an inflammation of the lining surrounding the lungs, causes sharp chest pain that intensifies with breathing, coughing, or sneezing. These respiratory symptoms can sometimes overlap with the chest discomfort associated with acid reflux.
When to Seek Medical Advice
Self-diagnosis can be dangerous, so consult a healthcare professional for an accurate diagnosis and appropriate treatment. Seek medical attention if you experience persistent or worsening symptoms despite over-the-counter treatments or lifestyle adjustments.
Immediate medical attention is necessary for specific red-flag symptoms, including:
Severe chest pain or pressure, especially if it radiates to an arm, the neck, or the jaw, or is accompanied by shortness of breath, dizziness, or cold sweats.
Difficulty swallowing or the sensation of food getting stuck.
Unexplained weight loss.
Persistent vomiting, especially if it contains blood or looks like coffee grounds.
Black, tarry stools.