Patients with GERD may have several symptoms, where typical GERD symptoms include cough, hoarseness, voice changes, chronic ear ache, burning chest pains, nausea or sinusitis. Patients may have the sensation that food is trapped behind the breastbone, due to that chest pain is a common symptom of GERD. Patients that have heartburn symptoms more than once a week are at risk of developing GERD, where a hiatal hernia is usually asymptomatic, but the presence of a hiatal hernia is a risk factor for development of GERD.