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By: by Amino Science
Heartburn, acid reflux, and GERD, or gastroesophageal reflux disease, are terms that are often used interchangeably. Yet while they’re all closely related, they don’t necessarily mean the same thing. So if you’ve ever stopped and thought about heartburn vs. acid reflux vs. GERD and wondered what the difference is, we invite you to read on. We’ll talk about the differences—and the similarities—and how you can find relief from all three!
Heartburn refers to a burning sensation felt in the center of the chest, directly behind the breastbone. The condition is caused by relaxation of the lower esophageal sphincter (LES)—a band of muscle located at the bottom of the esophagus.
Under normal circumstances, the LES remains tight until it needs to allow food and liquids to pass from the esophagus into the stomach, at which point it relaxes. However, sometimes the LES becomes weak or malfunctions and relaxes when it should be tight. When this happens, stomach acid refluxes back up into the esophagus.
The two most common heartburn symptoms are:
Many people have mistaken the sometimes excruciating pain of heartburn for something more sinister, like a heart attack, but occasional heartburn is actually quite common and not dangerous. In fact, the American College of Gastroenterology reports that more than 60 million Americans have the condition at least once a month.
Even though occasional episodes of heartburn are nothing to worry about, frequent heartburn can be a sign of a more serious condition.
Like heartburn, acid reflux occurs when the LES doesn’t tighten properly and allows stomach contents to flow back up into the esophagus. Yet heartburn is merely a symptom—albeit the most common one—of acid reflux.
In fact, aside from regurgitation and a bitter or sour taste in the mouth, you might not associate most symptoms of acid reflux with stomach acid. For example, symptoms may include:
As mentioned, everyone has acid reflux from time to time. However, if symptoms of acid reflux become chronic, the condition then becomes known as GERD. To be diagnosed with GERD, one of two situations must be present:
Unlike occasional acid reflux, the chronic inflammation caused by GERD can lead to serious complications due to damage to the lining of the esophagus. Some of these complications include:
In addition, frequent regurgitation of acid can lead to damage to the tooth enamel.
One thing heartburn, acid reflux, and GERD have in common is that they’re triggered by the same things. Risk factors associated with all three conditions include:
| Pregnancy | Obesity |
| Smoking | Hiatal hernia |
| Spicy foods | Fatty foods |
| Large meals | Garlic and onions |
| Citrus | Tomato products |
| Peppermint | Chocolate |
| Alcohol | Caffeinated or carbonated beverages |
| Antibiotics | Bisphosphonates |
| Iron and potassium supplements | Nonsteroidal anti-inflammatory drugs (NSAIDs) |
| Aspirin | Antidepressant and anti-anxiety medications |
Although your health care provider will probably be able to tell whether you have heartburn, acid reflux, or GERD based on your symptoms and a physical exam, they may choose to perform certain procedures to enable a more in-depth examination of the esophagus and stomach. These procedures may include:
Depending on the severity of your symptoms, your health care provider may recommend antacids to neutralize stomach acid or over-the-counter (OTC) or prescription medications to reduce the amount of acid produced by the stomach (histamine 2 blockers, or H2 blockers), decrease acid production and help heal the esophagus (proton pump inhibitors, or PPIs), or strengthen the LES (baclofen).
However, these medications aren’t without side effects. For example, several studies have shown that PPIs may cause severe rebound symptoms after withdrawal of the medication—and these symptoms can continue for weeks after stopping the PPI. Long-term use of PPIs is also associated with a risk of both dementia and kidney damage.
Moreover, a recent study found that long-term use of PPIs is associated with an increased risk of death. And H2 blockers and PPIs can both lead to vitamin B12 deficiency and fractures.
However, there’s no denying that GERD symptoms can lead to severe complications over time, and use of medications is certainly warranted in severe cases. But it’s important to note that most people can reduce or even eliminate symptoms by instituting simple lifestyle changes instead.
If you have symptoms of heartburn, acid reflux, or GERD, these simple lifestyle changes should help you get back on the road to health. However, if you continue to experience severe or frequent symptoms, be sure to speak with your health care provider for further treatment options.
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