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Is It Heartburn or Something More? Understanding GERD Symptoms

It happens to almost all of us at some point — we feel that burning sensation in the chest after a glass of wine, a dinner of spaghetti and meatballs, or that late-night bowl of potato chips. It’s heartburn and it happens when acid from the stomach spills into the esophagus, which is called acid reflux. It can be quite painful.

Heartburn and acid reflux are also both symptoms of gastroesophageal reflux disease (GERD). “It’s the same disease process,” said Emil Graf, MD, a general and bariatric surgery specialist with Banner Health.

So, how can you tell whether you’re having an episode of heartburn that you can treat on your own or symptoms of acid reflux or GERD that could need medical attention? Dr. Graf explained more about these conditions.

What’s the difference between GERD, heartburn and acid reflux?

Here’s what these three terms mean:

  • GERD is a medical condition where the stomach contents move backward into the esophagus. “The stomach produces quite a bit of acid, so if you have GERD it’s the acidic content that produces symptoms,” Dr. Graf said.
  • Heartburn is a sensation of burning in your chest. Occasional heartburn is common, but sometimes it can be more serious. 
  • Acid reflux is simply a way to describe what happens if you have GERD. 

Foods that can cause heartburn symptoms

According to the National Institutes of Health, certain foods often trigger common symptoms:

  • High-acid foods like citrus fruits and tomatoes
  • Alcohol
  • Chocolate
  • Coffee/caffeine
  • Mint
  • Fatty foods
  • Fried foods
  • Spicy foods

How to manage heartburn

If you experience heartburn occasionally, you can try to control it on your own:

  • Avoid foods that trigger your heartburn, especially in the afternoon or evening.
  • Take over-the-counter (OTC) antacids like Tums or Rolaids, or acid suppressors/proton pump inhibitors such as Prilosec, Nexium or Pepcid.

If medication isn’t working, you need to take it more than twice a week or you’re regurgitating (bringing up) acid, talk to your doctor. 

Symptoms of GERD

People with GERD may also have symptoms other than heartburn. Acid regurgitation is the most common. That’s when stomach contents can reach the back of your mouth and you notice a sour or bitter taste. 

“Acid regurgitation typically occurs at night when people are lying down flat, especially after eating a heavy meal or drinking water before bed. They burp up acid or feel acid in the back of the throat or mouth. It can cause a lot of discomfort,” Dr. Graf said.

Some less-common symptoms of GERD include:

  • Feeling like you have a lump in the throat that doesn’t go away when you swallow (called a globus sensation).
  • Voice fatigue or hoarseness that doesn’t go away.
  • Feeling like your voice gets tired quickly.
  • Trouble swallowing (dysphagia).
  • Cough, wheezing or asthma-like symptoms.
  • Frequent throat clearing.
  • Sore throat or throat irritation.
  • Chest pain that mimics heart-related discomfort. “Heartburn can be severe enough to be mistaken for chest pain or a heart attack,” Dr. Graf said.

When to connect with a health care provider

You should talk to your primary care provider or a gastroenterologist if:

  • You’re experiencing acid regurgitation or any of the less-common symptoms of GERD.
  • You need heartburn medication more than twice a week.
  • You’re taking OTC heartburn medication for more than two weeks.

At your appointment, be open and honest with your provider and:

  • Describe your symptoms.
  • Explain when they started, how often they happen and how long they last.
  • Share anything you think causes the symptoms or makes them worse. 
  • Tell your provider what makes you feel better, including any OTC medications.
  • Share any family history of GERD or other digestive conditions.

It’s important to get treatment because GERD symptoms aren’t just uncomfortable. In people with GERD, acid can inflame and damage the lining of your esophagus, which is called esophagitis. And over time, that damage can lead to a condition called Barrett’s esophagus, which makes it more likely that you could develop esophageal cancer.

To put together a treatment plan, your provider may start with an upper endoscopy. In this procedure, you’re sedated and a surgeon puts a scope through your mouth and into your esophagus and stomach to see if the acid has caused any damage. If there’s no damage, you can likely have follow-up endoscopies when you have your colonoscopies

Treatment options for GERD

“GERD is a very common problem, with very good medical treatment options once it’s diagnosed,” Dr. Graf said. 

Lifestyle changes can help. “Obesity and smoking are two of the most common contributing factors for GERD. People who are able to quit smoking and lose weight will almost always be able to resolve GERD without medication or surgery,” he said.

If you need medication, your provider may recommend prescription H2 blockers or proton pump inhibitors to control your symptoms.

If your esophagus is damaged or inflamed, or if medication doesn’t get your symptoms under control, your doctor may suggest surgery. “Surgical treatments for GERD are very effective. They can give you a lot of relief and keep GERD from getting worse,” Dr. Graf said.

The bottom line

It’s important to understand the difference between GERD and heartburn, since GERD is a long-lasting health condition that can cause more serious problems. A health care provider can troubleshoot your heartburn triggers, help diagnose GERD and walk through your treatment options. Reach out to Banner Health to connect with an expert.

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