GERD vs. Acid Reflux: What’s the Difference?

What is the difference between GERD and acid reflux?

Acid reflux

Acid reflux occurs when stomach acid flows back into the esophagus, the tube that connects your throat to your stomach. A valve at the entrance to your stomach, called the lower esophageal sphincter (LES), does not fully close when food passes through it. The LES is a ring of muscles that prevents stomach contents from flowing back into the esophagus.

The backflow of acid causes a burning sensation in your chest, known as heartburn or indigestion. It can cause symptoms such as nausea or regurgitation if it does not close properly. Regurgitation is when food returns to your mouth from your esophagus or stomach before you digest it.

“If you have an occasional uncomfortable burning feeling in your chest after eating, you are likely experiencing acid reflux,” said Elliott Birnstein, MD, Catholic Health Gastroenterologist. 

Acid reflux is also known as gastroesophageal reflux (GER). Many people have occasional acid reflux, which is usually not a cause for concern. However, frequent acid reflux can cause gastroesophageal reflux disease (GERD) that requires treatment by a physician.

GERD stands for gastroesophageal reflux disease, a more serious form of acid reflux. It causes abdominal discomfort after meals and may lead to serious health problems. A gastroenterologist can diagnose and treat GERD.

Dr. Birnstein noted that knowing the difference between acid reflux and GERD can help you know when to seek care and find treatment.

How does short-term heartburn differ from GERD and acid reflux?

“Although many people use the terms heartburn, acid reflux and GERD interchangeably, they are not the same,” said Dr. Birnstein.

He explained that heartburn, which has nothing to do with your heart, is a symptom of acid reflux and GERD. It occurs in the digestive system, particularly the esophagus.

Heartburn usually occurs after eating and may worsen when you bend over or lie down. It does not typically require medical attention. You can treat occasional heartburn with antacids or dietary changes.

 

What are the symptoms of acid reflux?

In addition to heartburn, common symptoms of acid reflux include:

• Bad breath
• Bloating
• Burping
• Chest pain
• Difficulty swallowing (dysphagia)
• Nausea
• Regurgitation

“Heartburn and indigestion are common symptoms of a heart attack,” said Dr. Birnstein. “If you are experiencing severe and persistent discomfort with other symptoms like chest pain or shortness of breath, seek immediate medical treatment.”

 

How do you treat acid reflux?

Acid reflux does not usually need medical attention. To treat it at home:

• Avoid certain foods, such as fatty, spicy or high-acid foods.
• Do not drink alcohol.
• Eat slowly. Try eating smaller meals more frequently.
• Take an over-the-counter antacid, such as Mylanta or Tums. Antacids help relieve heartburn and reduce stomach acid. They neutralize stomach acid by stopping an enzyme known as pepsin from creating acid to break down food for digestion.

If you have an “acid reflux attack,” stand up and take small sips of water to help wash away stomach acid. If your pants are too tight, loosen them or remove your belt. Tight-fitting clothing puts pressure on your stomach and can force stomach acid back up.  

 

When does heartburn become GERD?

Many people experience heartburn from time to time. Spicy, fried and fatty foods, coffee, tomatoes, citrus fruits and chocolate can trigger heartburn in many people. But you may have GERD if you have heartburn two or more times a week.

 

What are the symptoms of GERD?

Besides heartburn, symptoms of GERD include:

• Bad breath
• Bitter taste in the mouth
• Difficulty swallowing
• Feeling of a lump in your throat
• Hoarseness
• Nausea or vomiting
• Pain in the upper abdomen or neck
• Persistent cough
• Regurgitation of food or sour liquid

 

Who is at risk for GERD?

“Anyone can develop GERD, but certain factors increase your risk,” said Dr. Birnstein.

Risk factors include:

• Autoimmune diseases like lupus and rheumatoid arthritis
• Certain medicines for high blood pressure, depression or asthma
• Gastroparesis (delayed emptying of the stomach)
• Hiatal hernias (the upper stomach moves into the chest)
• Overweight or obese
• Pregnancy
• Smoke or exposure to secondhand smoke

Women tend to have GERD more often than men, and your likelihood of dealing with GERD increases with age. GERD may become more common in menopause because hormonal changes can affect the LES’s ability to relax.

 

What are the complications of GERD?

GERD can cause severe health complications if left untreated, including:

• Damaged tooth enamel
• Esophageal stricture that decreases the size of your esophagus and makes it difficult to swallow.
• Inflammation of the esophagus that causes ulcers and bleeding.
• Inflammation of your vocal cords causes you to lose your voice temporarily.

 

How is GERD treated?

“If you are diagnosed with GERD, your gastroenterologist will first recommend lifestyle modifications to alleviate symptoms,” said Dr. Birnstein. “If that does not help, you may need over-the-counter medicine, prescription medicine, or, in severe cases, surgical intervention.”

Diet and lifestyle modifications

Try these diet and lifestyle modifications to alleviate GERD symptoms:

• Avoid eating big meals and foods that trigger GERD symptoms.
• Avoid lying down immediately after eating. If your symptoms are worse at night, eat at least three hours before you go to bed.
• Chew slowly and thoroughly before swallowing.
• Drink warm water mixed with a small amount of lemon juice and honey to neutralize stomach acid.
• Eat alkaline foods like bananas, ginger, fennel, nuts and melons to offset stomach acid.
• Eat high-fiber foods like oatmeal, brown rice, root vegetables and green vegetables. These will make you feel full, so you are not tempted to overeat.

Nonfat milk and low-fat yogurt act as a temporary barrier between the stomach’s lining and its acidic contents. Watery foods like watermelon, cucumber, lettuce, broth and celery help dilute stomach acid.

If you are overweight or obese, your physician will likely recommend losing weight to reduce your GERD symptoms.

Medications

Certain medications reduce the amount of stomach acid your body produces, which can help relieve GERD symptoms. This is known as acid suppression therapy. Your physician will discuss the best options for you: over-the-counter (OTC) antacids or prescription medications.

Diagnostic testing and surgery

Lifestyle changes and medication are usually enough to manage GERD. If symptoms do not improve, your physician may run diagnostic tests, such as an upper gastrointestinal (GI) endoscopy or esophageal pH monitoring. During an endoscopy, a physician uses a thin, flexible tube called an endoscope to check the lining of the GI tract, including the esophagus and stomach, to check for complications of GERD. Esophageal pH monitoring detects stomach acid in the esophagus.

If symptoms continue, your physician may recommend surgery. A procedure known as Nissen fundoplication reinforces the LES to ensure it stays closed. A surgeon wraps the top of the stomach around the lower esophagus, making it less likely stomach acid will come back up. TIF (transoral incisionless fundoplication) is a minimally invasive procedure that treats GERD by reconstructing the valve at the top of the stomach. 

“Acid reflux and GERD are treatable,” said Dr. Birnstein. “Talk to your physician if your symptoms are interfering with your daily life to start treatment and avoid further health complications.”

 

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