Gastroesophageal reflux disease (GERD), is a condition in which heartburn is a symptom. Stomach acid refluxes up into esophagus and causes pain. This pain can be felt as a burning sensation behind the sternum or breastbone, either as a spasm or a sharp pain. Many times the pain of acid reflux can be mistaken for the pain of a heart attack.

The pain of acid reflux (heartburn) can remain in the lower chest or it can radiate to the back of the throat and be associated with waterbrash, a sour taste in the back of the throat. If there is acid reflux near the larynx (voicebox) in the throat, it may cause coughing episodes or hoarseness. Reflux over prolonged periods of time can be severe enough that acid wears away the enamel on teeth and causes decay. Symptoms are often worsened after heavy meals, leaning forward, or lying flat. Those affected may often awaken from sleep with heartburn.