Yes, sometimes I too exp the chest tightness and back discomfort from reflux. I use to love Alfredo Fettucini, but I've learned to stay away from it for the reason you're exp. I think the oil or butter used in preparing this dish, whether in fettucini or sauce, makes this a no no for me. I've ordered it a couple of times at local restaurants in my area in the past, and it was just simply greasy....Well, some restaurants will hire inexperienced food preparers to save a buck. Some of these individuals aren't anywhere near trained chefs or good cooks.. Also, I believe the high carbs are a big problem with this dish.
I have discovered over the yrs some offending foods may not show negative effects immediately, but many, many hrs or days afterwards. Maybe, the food is obviously just fermenting in the belly, later causing a problem.
I simply don't eat Taco's with or without sauce, but consuming coffee is a different story which doesn't bother me anymore. I've learned to not use any sugar, but love Hazelnut Cream. And, I only drink soda on occasion, but only sprite.
Hope this helps in some way.....And, I hope you began to feel better with reflux and sinus symptoms.