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Heartburn, Acid Reflux, or GERD: What’s the Difference?

For many Americans, Super Bowl Sunday is as much an excuse to dig into snacks as it is to tune in for the game. Each year, we eat more than a billion chicken wings and 10 million pizzas.1,2 Then we wash it all down with more than 300 million gallons of beer. Then we wash it all down with more than 300 million gallons of beer. The resulting heartburn is often enough to raise antacid sales at 7-Eleven by 20% the day after the big game.1

For about 60 million Americans, heartburn isn’t an aggravation isolated to one Sunday in February, but a condition they experience at least once a month, harming quality of life and disrupting normal activity.3

But what’s the science behind heartburn?

Understanding Heartburn, Acid Reflux, and GERD

The terms acid reflux, heartburn, and GERD are often used interchangeably, but they actually mean different things. Acid reflux is the backflow of stomach contents into the esophagus. The feeling of acid reflux is heartburn: a mild burning sensation in the mid-chest, often occurring after meals or when lying down.4

Gastroesophageal reflux disease (GERD) is a more serious form of acid reflux.4 In GERD, the backflow of stomach acid occurs chronically and causes damage to the body over time. Specifically, stomach acid irritates the lining of the esophagus, which can lead to serious complications. Chronic injury and inflammation can narrow the esophagus, making it difficult to swallow. The condition can also cause pain and ulcers.5

Chronic GERD may even lead to asthma symptoms, a chronic cough, or dental problems as corrosive stomach acid erodes tooth enamel.5,6 In rare cases, it can lead to cancer of the esophagus.5

GERD often stems from a weakened or relaxed sphincter in the lower part of esophagus. Like a hatch that doesn’t quite close, it allows stomach acid to backwash into the esophagus.5

Someone with GERD might experience heartburn or a burning sensation in the throat or a sour or bitter taste in the mouth. It might feel like food, liquid, or stomach acid coming up into the throat (regurgitation). Nausea, vomiting, and other stomach discomfort are common, as is pain or difficulty swallowing.5, 7

Sometimes, people mistake GERD symptoms with a heart attack. In a heart attack, heartburn and chest pain are often accompanied by arm pain. If you experience these systems, call 911.8

Getting Help for Heartburn, Acid Reflux, and GERD

Acid reflux and heartburn affect just about everyone, though it’s more common in people who smoke, are overweight, take certain medications, or are pregnant.3,9 Often, people are unsure if they should see their doctor. If the heartburn is frequent, severe, and doesn’t respond to over-the-counter medication, it’s time to get it checked out. The same goes for heartburn that causes pain or keeps you from doing things that you enjoy.3, 10

It's time to seek care when heartburn is accompanied by any of the following: difficulty or pain with swallowing, a persistent cough or worsening asthma, or when heartburn is accompanied by unintentional weight loss, nausea, vomiting, or bleeding.3, 10

Doctors often refer patients with heartburn to a gastroenterologist, a physician who specializes in the digestive system. The gastroenterologist then inventories symptoms. By writing down symptoms ahead of the visit, patients with heartburn ensure more comprehensive care.

The gastroenterologist may prescribe a diagnostic test called an endoscopy. During this procedure, the patient is sedated and enters a semi-lucid, twilight state. A specialist feeds a thin, flexible tube with a small camera attached down the patient’s throat. That enables the gastroenterologist to examine the esophagus and if needed, take a tissue sample for testing.3

Moving Past Acid Reflux, Heartburn, and GERD

People with heart burn, acid reflux and GERD have treatment options. Doctors may recommend making some lifestyle changes to reduce frequency and severity of symptoms. Eliminating common trigger foods (such as citrus fruits, tomato-based, onion, garlic, and chocolate) can help. Other common culprits include high-fat, spicy, or fried foods. Some beverages, including coffee, tea, carbonated drinks, and alcohol, can all lead to GERD and acid reflux. Sometimes tight clothes can force stomach acid into the esophagus, so a wardrobe change might make a difference. Quitting cigarettes and other tobacco products may also alleviate symptoms. And by elevating your head in bed and avoiding meals at night, you can also reduce heartburn.3, 4,5, 7

Beyond lifestyle modifications, treatment options are available. Antacids may offer relief, H2-receptor blockers may reduce stomach acid production while proton pump inhibitors can block stomach acid production.3

Finally, if GERD persists despite lifestyle modifications and medication, a doctor may recommend surgery.7

With evidence-based treatments at hand, there’s no reason to suffer with acid reflux, heartburn, or GERD. Relief may simply require a few adjustments to diet or lifestyle. A prescription medication can also extinguish heartburn.

People who suspect they have GERD can start by noting what foods trigger their symptoms and bringing that information to their doctor. No one should be surprised to find a few of their Super Bowl standbys on the list.

Sources

  1. 7 things that’ll sell like crazy because of the Super Bowl. Money.
  2. An estimated 12.5 million pizzas will be ordered on Super Bowl Sunday | American Pizza Community.
  3. Heartburn: What you need to know. NIH Medline Plus Magazine.
  4. What’s the difference between heartburn, acid reflux and GERD? Cleveland Clinic.
  5. Gastroesophageal reflux disease (GERD) - Symptoms and causes. Mayo Clinic.
  6. Ranjitkar S, Kaidonis JA, Smales RJ. Gastroesophageal reflux disease and tooth erosion. International Journal of Dentistry. 2012;2012:1-10.
  7. GERD (Chronic acid reflux): symptoms, treatment, & causes. Cleveland Clinic.
  8. Heart attack symptoms, risk factors, and recovery. Centers for Disease Control and Prevention.
  9. Smoking and the digestive system. Johns Hopkins Medicine.
  10. Heartburn - Symptoms and causes. Mayo Clinic.

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