Heartburn so bad it hurts to breathe

GERD affects about 20 percent of people in the United States. Left untreated, GERD can damage the esophagus and lead to health complications.

What Is GERD? 

When you swallow, a band of muscle around the esophagus, called the lower esophageal sphincter (LES), relaxes to let food and liquid into the stomach. It also prevents the stomach’s contents from flowing back up into the esophagus.

If the sphincter relaxes too much or becomes too weak, your stomach acid can flow back into your esophagus, which can irritate the lining of the esophagus.

Acid reflux is the main symptom of GERD. It can cause an uncomfortable burning in your chest or throat. This feeling is sometimes known as heartburn.

Additional symptoms of GERD include:

• Nausea
• Chest pain
• Chronic cough
• Difficulty swallowing
• A hoarse voice
• Bad breath

Health Complications Associated with GERD

Acid reflux exposes your esophagus to stomach acid. Your stomach is built to tolerate stomach acid, but your esophagus isn’t. Without treatment, GERD can damage your esophagus and lead to further health complications down the line.

Shortness of Breath (Dyspnea)

Shortness of breath, also known as dyspnea, occurs when you feel as though you can't get enough air into your lungs. You may also feel tightness in your chest.

Research suggests that GERD may be an underlying cause of asthma and other breathing problems. When stomach acid passes through the esophagus, it can cause irritation and swelling in the airways of your upper respiratory system, which includes your throat, nasal cavity, pharynx, and larynx.

Symptoms of dyspnea include:

• Shortness of breath after exertion
• Postnasal drip
• Labored breathing
• Feeling smothered
• Heart palpitations
• Wheezing
• Coughing

Esophagitis

Acid reflux can cause inflammation that can damage the tissue in your esophagus. This inflammation is known as esophagitis.

Esophagitis can lead to difficulty swallowing and chest pain. If left untreated, it can eventually damage the lining of the esophagus and cause other complications like scarring, difficulty swallowing, and narrowing of the esophagus.

Symptoms of esophagitis include:

• Food getting stuck in the esophagus
• Chest pain that lasts more than a few minutes
• Painful swallowing
• Heartburn

9 Serious Conditions That Can Feel Like Heartburn

Esophageal Ulcers

When the lining of the esophagus becomes damaged due to acid reflux it can cause small open sores called esophageal ulcers.

Esophageal ulcers typically occur in the lining of the lower part of the esophagus, where the esophagus meets the stomach.

Symptoms of esophageal ulcers are: 

• Heartburn
• Nausea
• Bloating
• Indigestion
• A burning sensation in the chest
• Discomfort when swallowing

Aspiration Pneumonia

Inhaling the stomach acid that rises into your throat can cause an infection in your lungs known as aspiration pneumonia. Aspiration pneumonia occurs when you breathe something other than air into your respiratory tract. Aspiration pneumonia caused by GERD isn't necessarily common, but it may happen as a consequence of chronically inhaling acid reflux.

Untreated aspiration pneumonia can be dangerous and lead to lung scarring or lung abscesses–inflamed, pus-filled cavities in your lungs.

Symptoms of aspiration pneumonia include:

• Coughing up greenish or dark phlegm
• Fatigue
• Fever
• Chest pain
• Shortness of breath
• Wheezing

Esophageal Stricture

Chronic acid reflux can also cause scarring or abnormal tissue growth in the esophagus. This can cause the esophagus to become tight and narrow.

This narrowing of the esophagus is known as esophageal stricture, and it can make it tough to swallow. This difficulty passing foods and liquids into the stomach can also lead to breathing complications.

Symptoms of esophageal stricture include:

• Burning sensation in the neck or throat
• Difficulty swallowing
• Feeling of food getting stuck in your throat

Esophageal Cancer

The damage to your esophageal tissue that GERD can cause can eventually lead to the development of esophageal cancer. Esophageal cancer is the seventh most common type of cancer worldwide.

This type of cancer starts at the inner layer of the esophagus and can spread throughout the other layers of the esophagus and other parts of the body.  

Symptoms of esophageal cancer include:

• Difficulty swallowing
• Chest pain
• Weight loss
• Coughing
• Hoarseness
• Indigestion
• Heartburn

Treatment and Prevention of GERD

If you are looking to prevent GERD or avoid some of these complications, adopting certain lifestyle changes can be a great start:

• Stop smoking: Smoking makes it challenging for the sphincter that separates the esophagus from your stomach to close after food enters the stomach.
• Limit your alcohol and caffeine intake: Alcohol and caffeine can cause acid reflux.
• Avoid certain foods: Avoid foods such as greasy, fried, or fatty foods. Eating high-fat foods can cause the lower esophageal sphincter to relax, allowing more stomach acid to back up into the esophagus. Additionally, highly acidic fruits like oranges, lemons and grapefruit can also cause or worsen GERD symptoms.
• Do not eat right before bedtime: Try to eat at least 2-3 hours before you go to bed. This allows the stomach time to digest properly, which should help decrease the risk of experiencing acid reflux.
• Manage your weight: Carrying extra weight around your stomach can push the stomach upwards, making it easier for acid to come into the esophagus.

Medications Used To Treat Acid Reflux

A variety of medications can be used to treat acid reflux, including:

• Antacids: Neutralize the acid in your stomach thereby relieving indigestion and heartburn.
• Proton pump inhibitors (PPIs): PPIs work by reducing the amount of acid your stomach makes.
• Prokinetics: Prokinetics help strengthen the lower esophageal sphincter and cause the contents of the stomach to empty faster.
• H2 blockers: H2 blockers work by reducing the amount of stomach acid secreted by glands in the lining of your stomach.

When Should I See a Doctor?

If you experience symptoms of GERD or intense acid reflux multiple times a week, you should consider seeing your healthcare provider. 

A Quick Review

Acid reflux is usually nothing to be worried about. However, if you experience GERD or acid reflux frequently and it is left untreated, it can lead to certain complications such as breathing problems, esophagitis, esophageal stricture, aspiration pneumonia, esophageal ulcers, or esophageal cancer.

The sooner you seek treatment for GERD or acid reflux, the more you can help decrease your chances of developing health complications due to GERD.

Was this page helpful?

Tell us why!

Sources

Health.com uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

1. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Definition and facts for GER and GERD.

2. Clarrett DM, Hachem C. Gastroesophageal reflux disease (GERD). Mo Med. 2018;115(3):214-218.

3. Campbell ML. Dyspnea. Crit Care Nurs Clin North Am. 2017;29(4):461-470. doi:10.1016/j.cnc.2017.08.006

4. Hu ZW, Xu H, Zhan Y, et al. The relationship between acid reflux and esophageal motility, esophagitis and cardiac morphology in gastroesophageal reflux disease. Zhonghua Yi Xue Za Zhi. 2019;99(44):3494-3499. doi:10.3760/cma.j.issn.0376-2491.2019.44.009

5. Okamoto T, Suzuki H, Fukuda K. Clinical and endoscopic characteristics of acute esophageal necrosis and severe reflux esophagitis. Medicine (Baltimore). 2021;100(44):e27672. doi:10.1097/MD.0000000000027672

6. Lee AS, Ryu JH. Aspiration pneumonia and related syndromes. Mayo Clin Proc. 2018;93(6):752-762. doi:10.1016/j.mayocp.2018.03.011

7. Masuda T, Kovacs B, Csucska M, Bremner RM, Mittal SK. Pathological implications of swallow-associated transient lower esophageal sphincter elevation. J Gastrointest Surg. 2020;24(12):2705-2713. doi:10.1007/s11605-019-04452-1

8. Schlottmann F, Dreifuss NH, Patti MG. Obesity and esophageal cancer: GERD, Barrett´s esophagus, and molecular carcinogenic pathways. Expert Rev Gastroenterol Hepatol. 2020;14(6):425-433. doi:10.1080/17474124.2020.1764348

9. Huang J, Koulaouzidis A, Marlicz W, et al. Global burden, risk factors, and trends of esophageal cancer: an analysis of cancer registries from 48 countries. Cancers (Basel). 2021;13(1):141. doi:10.3390/cancers13010141

   Does heartburn make it hurt to breathe?

   Shortness of breath, also called dyspnea, can happen when stomach acid that backs up into the esophagus enters the lungs, causing the airways to swell. This usually happens while sleeping or lying down, and it can cause a person to cough or wheeze when taking a breath, or make them feel breathless.

   Should I go to the ER for severe heartburn?

   If the pain is not relieved shortly after taking antacids, or is accompanied by these symptoms, seek emergency medical care: Squeezing/tightening in the chest. Feeling out of breath. Pain, aching or discomfort radiating from the chest to the arms, back or neck.