It’s Taco Tuesday and you’re basking in the glow of your last fish taco when it hits — that burning sensation that rises from your stomach into the back of your throat. It’s not an unfamiliar sensation, but you’re tired of the pain ruining your favorite foods. So what gives?
There’s a strong ring of muscle called the lower esophageal sphincter where your esophagus connects to the stomach. This muscle helps keeps food and digestive juices in the stomach where they belong. If the sphincter muscle relaxes when it shouldn’t, stomach fluids leak back up the esophagus. Stomach acids are very irritating to throat tissue, creating that familiar burning feeling.
Read More: Heartburn or Heart Attack? What Women Should Know
The Difference Between Heartburn, Acid Reflux and GERD
Though unpleasant, the occasional heartburn that can ruin your meals every now and then is common and usually not cause for concern. When it occurs more frequently, however, heartburn indicates a more serious issue, such as acid reflux disease and gastroesophageal reflux disease (GERD).
“Heartburn, acid reflux and GERD are related, but with some important differences,” says Dr. John Crisologo, FACG, a board-certified gastroenterologist at Beaufort Memorial Lowcountry Medical Group Specialty Care. “Acid reflux is what causes the burning feeling of heartburn. In most cases, heartburn is temporary and triggered by certain foods. Acid reflux disease causes chronic heartburn. GERD is a more severe, long-lasting form of acid reflux, and heartburn is just one of the symptoms.”
Another key difference is that GERD does not get better on its own. Left untreated, GERD can cause a variety of complications including Barrett’s esophagus, a condition that increases the risk of developing esophageal cancer.
Read More: Pain in the Gut
Options to Tame the Flames
Thankfully, there are a number of effective treatments for heartburn, acid reflux disease and GERD. Lifestyle changes, such as managing weight, eating smaller portions, and avoiding triggers (usually spicy, greasy or acidic foods) can help prevent heartburn symptoms. Over-the-counter antacid medications also provide relief for occasional heartburn.
If you have heartburn more than twice a week, or over-the-counter heartburn remedies no longer provide relief, it may be time to see a doctor. Prescription medications can help block the production of stomach acid and strengthen a weakened esophageal sphincter muscle, giving the esophagus a chance to heal. In the most severe cases, gastrointestinal surgery may be needed.
Find a gastroenterologist who can help you decode stomach pain or ask your primary care provider for a referral.
Occasional heartburn is often treatable with over-the-counter medication and/or lifestyle modification. Your
heartburn may be caused by a more serious condition, such as gastroesophageal reflux disease, also called GERD. Here are questions to answer if you think you might have GERD: If you answered yes to any of these questions, your heartburn warrants attention from a medical professional. People with long-standing chronic heartburn are at greater risk for serious complications including stricture (narrowing) of the
esophagus or a potentially precancerous condition called Barrett's esophagus. Is It Heartburn or Gastroesophageal Reflux Disease (GERD)?
What Is Acid Reflux?
Acid reflux is a problem that affects the muscle at the bottom of the esophagus. This muscle, called the lower esophageal sphincter (LES), closes off your stomach from your esophagus, preventing stomach acid and digested food from flowing backwards2.
When acid reflux occurs, the LES partially opens. This allows acid to leak into the esophagus, sometimes creating burning sensations.
Acid reflux happens to everyone occasionally. However, it may be a problem if it starts to occur regularly3.
What Causes Acid Reflux?
There are several foods and drinks that can trigger acid reflux, GERD, and heartburn. Common triggers include4:
- Spicy foods
- Fatty or greasy foods
- Chocolate
- Mint
- Acidic foods and drinks, such as citrus fruits or juices, tomatoes, garlic, and onions
- Carbonated drinks like soda or seltzer
- Caffeine drinks like coffee and tea
- Alcohol
Acid Reflux Symptoms
You may not always know when you’re experiencing acid reflux — symptoms often don’t develop3.
Heartburn is a common symptom of acid reflux. Heartburn leads to a burning pain in the center part of your chest, behind your breastbone. You may also feel the burning sensation in your neck or in the back of your throat2.
Acid reflux may also lead to regurgitation, which happens when stomach acid, food, and other stomach contents come back up into your mouth. You may notice an acidic taste in your mouth, or be able to taste food that you recently ate2.
What Is Gastroesophageal Reflux Disease (GERD)?
GERD is acid reflux that occurs often or is more severe than normal. A doctor may diagnose you with GERD if you notice heartburn or other symptoms at least twice per week, or if your esophagus shows signs of damage3,5.
GERD is common. It affects about one out of five people in the United States3.
What causes GERD?
You may develop GERD if you tend to follow a diet full of foods that can cause acid reflux, eat large meals, or have dinner soon before heading to bed4.
Some risk factors can also increase the chances that you develop GERD. These include2,5:
- Being overweight or obese
- Pregnancy
- Older age
- Smoking cigarettes
- Having a hiatal hernia (a condition in which part of your stomach bulges upward, through the diaphragm muscle, into your chest)
Certain medications also lead to GERD as a side effect. You may develop GERD if you are taking non-steroidal anti-inflammatory drugs (NSAIDs), benzodiazepines, high blood pressure medications such as calcium channel blockers, asthma drugs, or tricyclic antidepressants2.
GERD Symptoms
Like acid reflux, GERD can also lead to heartburn and regurgitation. GERD can also cause2:
- Being overweight or obese
- Nausea
- Painful or difficult swallowing
- Chest pain
- Frequent coughing
- A hoarse voice
If GERD is left untreated for a long period of time, it can also lead to additional problems. Some long-term health effects of GERD include1:
- Esophagitis — Inflammation of the tissue of the esophagus
- Esophageal stricture — A condition in which the esophagus narrows
- Barrett’s esophagus — A change in which the esophagus tissue starts to look like tissue found in the intestines, and people with Barrett's may develop a rare cancer called esophageal adenocarcinoma
- Asthma — Inflammation of the airways
- Laryngitis — Swelling and irritation of the voice box
- Tooth erosion — A condition in which the outer layer of enamel on the teeth wears down
GERD Diagnosis
If your doctor suspects that you might have GERD, they may perform a physical exam and ask you about your GERD symptoms. They may also recommend several tests.
The most common diagnostic test used to look for signs of GERD in the esophagus is an upper endoscopy6. During this test, a doctor passes a long tube into your mouth and through your esophagus, stomach, and upper part of your small intestine. The tube has a camera at the end, so the doctor can see what the lining of the esophagus looks like. During an endoscopy, the doctor may take a biopsy — this means removing a small sample of tissue so that it can be further studied in the lab7.
Doctors may also recommend esophageal pH monitoring. This test measures acid in the esophagus using either a catheter (narrow tube) or a wireless capsule that transmits information to a receiver device7.
PEPCID® is not indicated for the treatment of acid reflux or GERD. If you experience symptoms of acid reflux for more than two weeks, see your doctor.
Dealing With Heartburn
Heartburn is the name of a symptom — a burning feeling in your chest, neck, or throat — that can be caused by both acid reflux and GERD1. To help manage heartburn symptoms, learn more about possible causes and potential treatments.
PEPCID® can provide fast-acting, effective relief of occasional heartburn
References
- 1Definition & Facts for GER & GERD. National Institute of Diabetes and Digestive and Kidney Diseases. Reviewed July 2020. Accessed December 13, 2021.
- 2Newberry C, Lynch K. The role of diet in the development and management of gastroesophageal reflux disease: why we feel the burn. J Thorac Dis. 2019;11(Suppl 12):S1594-S1601.
- 3Eating, Diet, & Nutrition for GER & GERD. National Institute of Diabetes and Digestive and Kidney Diseases. Reviewed July 2020. Accessed December 13, 2021.
- 4Lechien JR, Bobin F, Muls V, et al. Patients with acid, high-fat and low-protein diet have higher laryngopharyngeal reflux episodes at the impedance-pH monitoring. Eur Arch Otorhinolaryngol. 2020;277(2):511-520.
- 5Fan WJ, Hou YT, Sun XH, et al. Effect of high-fat, standard, and functional food meals on esophageal and gastric pH in patients with gastroesophageal reflux disease and healthy subjects. J Dig Dis. 2018;19(11):664-673.
- 6High-fiber foods. MedlinePlus. Reviewed August 20, 2020. Accessed December 13, 2021.
- 7Badillo R, Francis D. Diagnosis and treatment of gastroesophageal reflux disease. World J Gastrointest Pharmacol Ther. 2014;5(3):105-112.
- 8Mone I, Kraja B, Bregu A, et al. Adherence to a predominantly Mediterranean diet decreases the risk of gastroesophageal reflux disease: a cross-sectional study in a South Eastern European population. Dis Esophagus. 2016;29(7):794-800.