Heartburn is a substernal burning pain that rises in the chest and may radiate into the neck, throat, or even face. It usually occurs after meals or when lying down. Heartburn may be accompanied by regurgitation of gastric contents into the mouth and subsequent water brash, which is hypersalivation occurring via vagal stimulation when acid irritates the lower esophagus. Odynophagia is pain during swallowing. The patient may describe the pain as a burning sensation or a substernal tightness typically elicited by very hot or very cold food or liquid.
Pain occurs promptly with swallowing.
Severe squeezing chest pain, induced by swallowing hot or cold beverages in association with dysphagia, is characteristic of esophageal motor disorders. Spontaneous esophageal motor disorder pain is difficult to differentiate from other esophageal symptoms and cardiac chest pain. Spontaneous esophageal chest pain may be severe and mimic angina pectoris. Definitive diagnosis is not possible unless the motor disorder can be recorded during manometry concurrent with the patient's typical pain. The presence of dysphagia with chest pain may indicate an esophageal origin.