The terms heartburn, acid reflux, and GERD are often used interchangeably. They actually have very different meanings.
Acid reflux is a common medical condition that can range in severity from mild to serious. Gastroesophageal reflux disease (GERD) is the chronic, more severe form of acid reflux. Heartburn is a symptom of acid reflux and GERD.
What is heartburn?
The term “heartburn” is misleading. The heart actually has nothing to do with the pain. Heartburn occurs in your digestive system. Specifically, in your esophagus. Heartburn involves mild to severe pain in the chest. It’s sometimes mistaken for heart attack pain.
The lining of your esophagus is more delicate than the lining of your stomach. So, the acid in your esophagus causes a burning sensation in your chest. The pain can feel sharp, burning, or like a tightening sensation. Some people may describe heartburn as burning that moves up around the neck and throat or as discomfort that feels like it’s located behind the breastbone.
Mild, infrequent heartburn can also be treated with medications like antacids. If you take antacids more than several times a week a doctor should evaluate you. Your heartburn may be a symptom of a more severe problem like acid reflux or GERD.
What is acid reflux?
A circular muscle called the lower esophageal sphincter (LES) joins your esophagus and stomach. This muscle is in charge of tightening your esophagus after food passes to the stomach. If this muscle is weak or doesn’t tighten properly, the acid from your stomach can move backward into your esophagus. This is known as acid reflux.
Acid reflux can cause heartburn and other symptoms that include:
bitter taste in the back of the throat
sour taste in the mouth
burning and pressure that can extend up the breastbone
What is GERD?
GERD is the chronic form of acid reflux. It’s diagnosed when acid reflux occurs more than twice a week or causes inflammation in the esophagus. Long-term damage of the esophagus can lead to cancer. Pain from GERD may or may not be relieved with antacids or other over the counter (OTC) medication.
Symptoms of GERD include:
damage to tooth enamel due to excess acid
feeling like stomach contents have come back up to the throat or mouth, or regurgitation
persistent dry cough
Most people can experience heartburn and acid reflux intermittently related to something they ate or habits like lying down immediately after eating. However, GERD is a chronic condition where doctors start to examine long-lasting habits and parts of a person’s anatomy that could cause GERD. Examples of the causes of GERD include:
being overweight or obese, which puts extra pressure on the stomach
hiatal hernia, which reduces pressure in the LES
taking medicines known to weaken the LES, such as antihistamines, calcium channel blockers, pain-relieving medicines, sedatives, and antidepressants.
Symptoms of GERD may disrupt your daily life. Fortunately, they can usually be controlled with treatment. Options include:
Medications for GERD work to reduce the amount of acid in the stomach. They may not be effective for everyone. Some people need surgery to help reinforce the LES.
Complications of GERD
Acid from the stomach can damage the lining of the esophagus if GERD is left untreated. This can cause:
The acid can also cause a change in the cells in the esophagus over time. This is called Barrett’s esophagus. About 10 to 15 percent of people with GERD will develop this condition. Barrett’s esophagus increases your risk for a type of esophageal cancer known as adenocarcinoma. Experts believe that most cases of this type of esophageal cancer start from cells within Barrett’s tissue.
Medical treatments for GERD
Medications are available with and without a prescription for acid reflux and GERD.
Antacids: First-line treatments for acid reflux are usually antacids. These medicines act quickly to reduce the effect of stomach acid, which can relieve symptoms. Examples of these medicines are Tums and Rolaids.
If these medicines don’t relieve acid reflux or a person has GERD, other treatments can include:
H2 blockers: H2 blockers are designed to reduce the amount of acid a person’s stomach produces. Sometimes taking these medicines with antacids can help. Examples of these medicines include cimetidine (Tagamet) and famotidine (Pepcid).
Proton pump inhibitors: These medications work longer than H2 blockers to reduce acid in the stomach. They can also help heal the stomach lining. Examples include:
lansoprazole (Prev acid)
Prokinetics: These are medications like metoclopramide (Reglan). There is controversy as to whether these medications benefit people with GERD. Many new prokinetics have been removed from the market due to serious side effects.
If medications don’t reduce a person’s acid reflux symptoms, a doctor may recommend surgery to avoid further damage to the esophagus and stomach. One surgical approach is known as Nissen fundoplication. This involves wrapping a portion of your stomach around the esophagus to strengthen the LES.
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