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How to Tell the Difference Between Heartburn and GERD?

cartoon man with heartburn

The terms heartburn, acid reflux, and gastroesophageal reflux disease (GERD) are often used interchangeably, but there are subtle differences between them. This article will help you to understand these conditions better so that you know when it is okay to treat them at home versus when to see a doctor.

What is heartburn?

Heartburn is a burning pain in the chest. It is a somewhat misleading term because heartburn has nothing to do with the heart. It refers to pain near the heart. Specifically, it is a sharp, burning pain and/or tightening sensation in the lower chest, just behind the breastbone. The pain can sometimes feel like it’s moving up towards the neck. Heartburn is sometimes mistaken as a sign of a heart attack.

In truth, heartburn is a condition of the digestive system, specifically of the esophagus or food pipe. When the esophageal sphincter does not function properly, it causes the stomach contents to regurgitate into the esophagus. When the esophageal lining, which is more delicate than to the stomach lining, is exposed to stomach acid, it becomes irritated and you get heartburn symptoms. 

Many people suffer from occasional heartburn. Indeed, it is estimated that some 60 million Americans get heartburn at least once a month. The burning pain can occur after a large meal, especially in the evening, or when bending over or lying down. 

Mild, infrequent heartburn is not a cause for concern. It can usually be managed with over-the-counter medications like antacids. Lifestyle changes such as stopping smoking, losing weight, eating less fried and fatty foods, and avoiding spicy or acidic foods can also help.

However, if heartburn occurs frequently or is severe enough to interfere with your daily routine, it could be a symptom of something more serious, including esophageal cancer. Ignoring persistent heartburn symptoms can have severe health consequences. You should get checked out by a medical professional if you have heartburn more than once or twice a week. 

What is acid reflux?

To understand acid reflux, we must first understand the anatomy of the digestive system. The lower end of the esophagus (food pipe) joins the stomach. At this location, there is a circular muscle called the lower esophageal sphincter or LES. This muscle tightens after food passes into the stomach. It prevents stomach acid from irritating the lining of the esophagus. Acid reflux occurs if the LES muscle is weak or cannot tighten properly. In such cases, the acid from the stomach is able to backwash into the esophagus and irritate the lower esophagus, causing a burning feeling, which is called heartburn. 

Therefore, heartburn is a symptom of acid reflux. Other symptoms of acid reflux can include sore throat, cough, trouble swallowing, sour or bitter taste in the back of the mouth or throat, and a burning or pressure sensation in the chest.

Certain foods like acidic, spicy, and fried and fatty foods can aggravate acid reflux.

What is GERD (gastroesophageal reflux disease)?

Gastroesophageal reflux disease (GERD) is a more severe form or chronic form of acid reflux. It is called gastroesophageal reflux disease when a person has mild acid reflux at least twice a week or severe acid reflux at least once a week. 

Common causes of GERD include being overweight or obese, smoking, and drinking alcohol. It also occurs in pregnant women. A condition called hiatal hernia (in which there is bulging of the upper part of the stomach into the chest) can cause GERD. Certain medications like pain relievers, calcium channel blockers, antihistamines, sedatives, and antidepressants can weaken the lower esophageal sphincter (LES) and cause GERD.

While some people can manage GERD with over-the-counter medication and/or lifestyle changes, others need stronger (prescription) medications like proton pump inhibitors or even surgery to reduce symptoms.

It is important to seek medical care and get proper treatment for gastroesophageal reflux disease. Untreated GERD and chronic (long-term) inflammation of the esophagus can lead to several health issues and complications like Barrett’s esophagus and an increased risk of esophageal cancer. 

What does a GERD flare-up feel like?

Most people with GERD suffer from frequent heartburn, which, as mentioned, is a sharp, burning pain or tightening sensation behind the breastbone. Some people feel like food is coming back into their mouth, leaving them with a bitter or acidic (sour) taste in the mouth. A GERD flare-up typically occurs after large meals and can last for two to three hours. 

How do you check if you have GERD?

In addition to heartburn, GERD can cause the following symptoms:

  • A sensation of a lump in the throat 
  • A feeling that stomach contents have regurgitated (come back into the throat or mouth)
  • Bad breath
  • Cough
  • Difficulty swallowing
  • Difficulty breathing
  • Chest pain
  • New or worsening asthma
  • Difficulty sleeping
     

Can I test myself for GERD?

Only a healthcare provider can diagnose GERD. If you suspect you have this condition, you should see a doctor to know for sure. Do not try to self-diagnose and treat your GERD symptoms with an over-the-counter medication. Common symptoms of GERD can be indicative of a more serious health issue that may be treatable if discovered early.

How can you tell the difference between heartburn and acid reflux?

As mentioned above, heartburn is one of the symptoms of acid reflux. Many people experience symptoms of acid reflux occasionally, related to habits or diet. Infrequent and mild acid reflux can be treated with over-the-counter antacids and lifestyle changes. GERD is a chronic condition which needs to be evaluated and treated by a doctor. If you find yourself reaching for antacids more than twice a week, you should see a healthcare professional who can provide medical advice.
 

References

  1. https://www.mayoclinic.org/diseases-conditions/heartburn/symptoms-causes/syc-20373223
  2. https://www.mayoclinic.org/diseases-conditions/gerd/symptoms-causes/syc-20361940
  3. https://gi.org/topics/acid-reflux/