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Clinical features

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

These include:

  • retrosternal or epigastric pain described by the patient as heartburn or a burning sensation:
    • aggravated by postural change such as bending, stooping, or lying down, and by tight clothing which forces acid up into the oesophagus.
    • may be referred to the neck, shoulder or arms, so mimicking angina.
  • reflux is bitter or sour, reflecting its origin from the stomach. It is relieved by alkali.
  • dysphagia - a late symptom. It may be caused by muscle spasm secondary to irritation, or be due to oedema, inflammation, spasm or rarely, stricture resulting from acid peptic regurgitation.
  • "globus hystericus" - a chronic sensation of a foreign object lodged in the throat, tightness of the throat and a difficulty to initiate swallowing. Believed to be due to irritation and spasm in the cricopharyngeal sphincter region.
  • respiratory symptoms - recurrent pneumonia, lung abscess and bronchiectasis - but a causal relationship is unproven. Coarse crepitations may be discernible at the lung bases.
  • pallor due to occult bleeding and consequent anaemia and lethargy
  • haematemesis - due to ulcerative bleeding.
  • odynophagia

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