The Differences Between GERD, Heartburn, and Acid Reflux
You may have heard your peers or even your provider use the terms heartburn, acid reflux, and GERD interchangeably, but the terms in fact refer to three different conditions or symptoms. Understanding your diagnosis allows for maximum treatment and symptom management.
Despite its name (and the fact that its symptoms sometimes mimic heart attack symptoms), heartburn is unrelated to the heart. Heartburn refers to the burning pain that results from acid reflux, when digestive acid seeps or splashes into the esophagus from the stomach. This occurs when the lower esophageal sphincter, which should close tightly to keep digestive acids in the stomach, opens too often or does not close tight enough. Simply put, the pain is heartburn and the action of stomach acid splashing back into the esophagus is acid reflux. Heartburn and mild acid reflux can most often be treated by diet modification and over the counter antacids such as Tums and Rolaids.
Gastroesophageal reflux disease, or GERD, is chronic irritation of the lining of the esophagus due to acid reflux. Symptoms of GERD include sore throat, difficulty swallowing, heartburn, bad breath, hoarseness, indigestion, and cough. Untreated GERD can result in serious complications including Barrett’s esophagus, esophagitis, ulceration, and an increased risk of cancer.
Your provider may order a barium swallow x-ray, an endoscopy, pH monitoring, or an esophageal biopsy to diagnose GERD.
The goal of treating GERD is to reduce the amount of acid in the stomach as well as the amount of reflux into the esophagus. Over the counter antacids may be used to treat mild GERD, but prescription histamine blockers and proton pump inhibitors are typically required for severe GERD. A medication called Carafate may be prescribed in conjunction with other treatment to coat and protect the esophagus. Your doctor may also recommend that you do not eat or drink before bedtime, that you eat small meals more frequently, that you avoid acidic foods or foods that relax the lower esophageal sphincter, and that you raise the head of your bed to alleviate symptoms and prevent damage. It may also be beneficial to keep a food journal to determine which foods cause you discomfort.
Occasionally, GERD can be caused by an underlying issue such as celiac disease, hiatal hernia, or h. pylori infection. If your doctor suspects you may have any other health condition, he or she may order additional tests.
Although many people are able to manage GERD with diet changes and over the counter medications, it is important to seek treatment when your symptoms disrupt your daily life or result in difficulty swallowing or significant weight loss. Most times, a primary care or family practice doctor can manage GERD, but in complicated cases, you may be referred to a gastroenterologist for specialized treatment and care.
Remember, heartburn and heart attack symptoms can be similar. If you ever experience sudden worsening or pain that radiates to the arm or jaw, call 911 immediately.