What are the symptoms of reflux esophagitis?

Updated: May 02, 2019
  • Author: Deepika Devuni, MBBS; Chief Editor: BS Anand, MD  more...
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Answer

The most common complaint in patients with esophagitis is heartburn (dyspepsia), a burning sensation in the midchest caused by the contact of stomach acid with the esophageal mucosa. Symptoms often are maximal while the person is supine, bending over, or wearing tight clothing or after the person has eaten a large meal. The patient may complain of water brash, a bitter taste of refluxed gastric contents often associated with heartburn. [1]

The American College of Gastroenterology (ACG) published updated guidelines for the diagnosis and treatment of gastroesophageal reflux disease (GERD) in 2013. [49] According to the ACG guidelines, regurgitation and heartburn, separately or in conjunction, are the symptoms most specific for GERD. For patients with symptoms of uncomplicated GERD, the diagnosis of GERD may be assumed and empiric PPI therapy begun. For patients who show signs of GERD complications or other illness or who do not respond to therapy, further diagnostic testing should be considered.

Other common symptoms of esophagitis include upper abdominal discomfort, nausea, bloating, and fullness. Less common symptoms of esophagitis include dysphagia, odynophagia, cough, hoarseness, wheezing, and hematemesis.

The patient may experience chest pain indistinguishable from that of coronary artery disease. Pain is often midsternal, with radiation to the neck or arm, and may be associated with shortness of breath and diaphoresis. Chest pain may be relieved with nitrates if esophageal spasm is involved, further confounding the diagnostic evaluation.

Infants with gastroesophageal reflux are at a greater risk of aspiration. Symptoms include weight loss, regurgitation, excessive crying, backache, respiratory distress, and apnea.


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