What’s the Difference Between Acid Reflux and GERD?A burning pain in your chest generally signals heartburn, right? But if you were thinking that heartburn, also known as acid reflux, is the same as gastroesophageal reflux disease, read this.
Got a burning feeling in your upper chest? If you’re thinking heartburn, you’re probably right. “Heartburn is the manifestation — the symptom — of acid reflux, or stomach contents coming back up in your esophagus,” says Matilda Hagan, MD, a gastroenterologist at The Center for Inflammatory Bowel and Colorectal Diseases at Mercy Medical Center in Baltimore.
You can often pinpoint a reason for the burn (that five-alarm chili, perhaps?), but if heartburn happens often — defined as a couple of times a week — it could be a symptom of a more serious condition called gastroesophageal reflux disease (GERD).
While it may seem that GERD is just a fancy name for heartburn, they are more like close cousins than identical twins.
That Burning Feeling: What Is Heartburn?
After you swallow food, it makes its way down the esophagus and into the stomach, where a ring of muscle, called the lower esophageal sphincter (LES), closes to keep the food in. But sometimes the LES is weak or doesn’t properly close, allowing stomach acid to backup, which irritates the lining of the esophagus. That’s acid reflux, or heartburn.
coleman 6 person tent with porch Heartburn Relief (☑ Causes) | coleman 6 person tent with porch 23+ Home Remedieshow to coleman 6 person tent with porch for The American College of Gastroenterology (ACG) estimates that more than 60 million Americans experience heartburn at least once the 1 last update 2020/07/06 a month. Symptoms include:The American College of Gastroenterology (ACG) estimates that more than 60 million Americans experience heartburn at least once a month. Symptoms include:
- A burning sensation in the center of your chest that lasts from several minutes to an hour or two
- A feeling of chest pressure or pain that is worse if you bend over or lie down
- A sour, bitter, or acidic taste in the back of your throat
- A feeling that food is “stuck” in your throat or the middle of your chest
You can generally avoid occasional bouts of heartburn with some lifestyle modifications. Your doctor will likely suggest you try to treat heartburn by making the following lifestyle changes before medication comes into play.
When Acid Reflux Is Chronic: What Is GERD?
According to the ACG, GERD is acid reflux that occurs more than a couple of times per week. That said, it’s not the case that a person who has occasional heartburn will necessarily progress toward having GERD, says Louis Cohen, MD, gastroenterologist and assistant professor of medicine at the Icahn School of Medicine at Mount Sinai Hospital in New York City. But the symptoms are the same as those of acid reflux, such as the burning feeling in your chest and the sensation that your stomach contents are in your throat. You may also have a dry cough or trouble swallowing.
Diagnosing the condition can usually be done by a primary care doctor (or gastroenterologist) by simply evaluating symptom frequency and severity.
“We may also put a probe into a patient’s esophagus for a day to measure how frequently reflux happens,” says Dr. Cohen. Knowing how often reflux occurs is another way (beyond symptoms) to confirm a diagnosis.
Treatment for GERD starts with lifestyle modifications, adds Hagan, “we’ll ask patients to try these steps before we offer medication, although we understand that it can be hard to do some things, such as quitting smoking.”
The medication most often prescribed for GERD is a proton pump inhibitor (PPI), such as:
PPIs work to decrease the amount of acid your stomach produces. The ACG notes that there’s strong evidence that an eight-week course of a PPI eases symptoms and can heal the lining of the esophagus that’s been damaged by stomach acid. Other drugs called H2 blockers, such as Zantac (ranitidine) or Pepcid (famotidine) may also be tried and are effective, says Hagan. H2 blockers also lower stomach acid production, and are available over the counter.
“If we determine that GERD symptoms are caused by hypersensitivity in the the 1 last update 2020/07/06 esophagus or excessive relaxation of the lower esophagus, we might prescribe tricyclic antidepressants or selective serotonin uptake inhibitors,” adds Cohen.“If we determine that GERD symptoms are caused by hypersensitivity in the esophagus or excessive relaxation of the lower esophagus, we might prescribe tricyclic antidepressants or selective serotonin uptake inhibitors,” adds Cohen.
Delaying Treatment May Lead to Complications
If GERD goes untreated, it can lead to more serious complications. One such issue is esophagitis, which is inflammation in the esophagus. Hagan says if that’s not treated, you may develop strictures, which is a narrowing of the esophagus that can lead to esophageal pain and affect proper swallowing.
Another complication of GERD is a condition called Barrett’s Esophagus (BE). “Over time, the stomach acid causes cells in the lining of the esophagus to look more like the stomach lining,” says Hagan. These changes, which happen on a cellular level, may in rare cases lead to a form of esophageal cancer called esophageal adenocarcinoma. BE is more common in:
- Caucasian males
- People older than age 50
- People who are overweight
This form of cancer appears to be on the rise, according to research published in March 2013 in the journal Cancer.
Meanwhile more recent research, published in May 2016 in the Journal of the American Medical Association, suggests that the “chemical burn” of stomach acid may not be the sole cause of changes to the esophageal lining. Instead, the study suggests that damage may be caused by an inflammatory response to proteins called cyotokines that are secreted in the intestinal lining of people with GERD.
If you have BE, says Hagan, your doctor may recommend surveillance endoscopy, which means he or she will perform an endoscopy periodically to see how well your esophagus is healing, secondary to drug therapy.
The bottom line: If you’re experiencing heartburn at an increased frequency, talk to your doctor about testing to uncover the underlying issue. If you learn to treat GERD with lifestyle changes or medication, you can avoid more serious complications.