How to tell the difference between heartburn and gastroesophageal reflux disease

Have you ever felt a burning sensation in your throat or chest after eating a large meal? Many people experience heartburn symptoms from time to time. And despite the name, it has nothing to do with your heart. It’s actually caused from stomach acid.¹

If you get heartburn regularly, you may have a more serious, long-lasting condition called gastroesophageal reflux disease (GERD).² Heartburn is one symptom of GERD, which affects about 20% of people in the United States.³

Read on to learn the difference between them, how to treat symptoms and when to consult your doctor.

Also known as gastroesophageal reflux (GER), heartburn is a painful feeling in the middle of your chest or throat. It happens when stomach acid comes back up into your esophagus (the tube that connects your stomach to your throat).¹

Food is meant to travel down the esophagus. Occasional heartburn is uncomfortable, but it can usually be managed with lifestyle changes and/or medication.

If you’re having heartburn, it’s a good idea to track your symptoms. For example, write down when it happens, and what you ate or drank. If you find your heartburn is happening more often, talk to your doctor about GERD.

Common symptoms of heartburn include:¹

• A bitter taste in the mouth
• Pain worsens when laying down or bending over
• Nausea
• Burping

GERD is a disease that can lead to serious complications if not treated.² GERD happens when stomach acid flows up into the esophagus (causing heartburn) over a long period of time.⁴ Did you know gastric acid from your stomach is toxic to the esophagus? That’s why long-term acid reflux from GERD can cause permanent damage to this tube.³

Having untreated GERD can lead to things like an ulcer in the esophagus and even cancer.³ Chronic acid reflux from GERD may also wear away the enamel on your teeth. This dental erosion may lead to hypersensitivity and tooth loss.⁵

Common symptoms of GERD include:^2,3

• Severe and consistent heartburn
• Problems or pain when swallowing
• Aggravated asthma
• Coughing or hoarseness
• Laryngitis

If your symptoms don’t go away, talk with your doctor. You should also call your doctor if you’re having difficulty swallowing, chest pain, unexplained weight loss, or black or bloody stools.³

Your provider may refer you to a gastroenterologist, a doctor who specializes in digestive diseases and disorders. Your gastroenterologist may recommend an endoscopy. This is a procedure in which a flexible tube with a small, lighted camera is used to look at the inside of your esophagus, stomach and part of your small intestine. ⁶

Or they may recommend something called esophageal pH testing, which measures acid reflux in the esophogus.³

Factors that can contribute to heartburn and GERD include pregnancy, smoking and breathing in secondhand smoke.² Other factors include:

Issues inside the body. There are many ways the body prevents acid from leaving your stomach. A flap at the bottom of the esophagus is meant to prevent gastric acid from rising. Your breathing muscle, or diaphragm, also helps prevent acid from moving upward. The downward pull of gravity helps too.³

In people with GERD, these barriers are weakened from lifestyle habits and problems like a hiatal hernia.³

Being overweight. Carrying extra pounds can also cause normal barriers to weaken.²

Lying down after a big meal. Stretching out on your couch or bed after a meal can trigger acid reflux. That’s because when you’re lying horizontally, gravity no longer keeps stomach acid down. ⁷

Certain medications. These include benzodiazepines (sedatives), calcium channel blockers (for high blood pressure), certain asthma medications, nonsteroidal anti-inflammatory medications (like ibuprofen) and tricyclic antidepressants.⁴

Certain foods and drinks. “Common food triggers include chocolate, alcohol, coffee, citrus and tomato-based products,” explains registered dietitian Renee Korczak, Ph.D. Other things that may contribute to heartburn include fatty or spicy foods and peppermint.³ “Each individual is unique and there may be other contributing factors to GERD and heartburn beyond food,” says Dr. Korczak.

Fortunately, there are steps you can take at home, or under your doctor’s care, to treat symptoms.

• These habits may help ease symptoms:^3,7
• Limit or avoid foods that are potential triggers
• Avoid eating 2-3 hours before bedtime or lying down
• Raise your pillows or the head of your bed up 6 to 8 inches
• Sleep on your left side
• Reach and maintain a healthy weight
• Make a plan to quit smoking

Talk with your doctor if lifestyle changes don’t offer relief from your symptoms. You may need an over-the-counter (OTC) or prescription medication. OTC medications that may help reduce symptoms of occasional heartburn and GERD include:⁸

• Antacids: Antacids neutralize or change the acid created in your stomach.¹ If you find you’re using antacids more than twice a week, reach out to your health care provider.
• H2 blockers: H2 blockers, or histamine 2 blockers, reduce the amount of stomach acid that’s produced and work for several hours. They may interact with other medications, so if you’re taking other meds, you may want to talk to your doctor or pharmacist before using them.⁸
• Proton pump inhibitors: Similar to H2 blockers, proton pump inhibitors (PPIs) also reduce the amount of acid your stomach produces. (And they may also interact with other meds.) It can take 1 to 4 days for these medications to fully kick in.⁸

If lifestyle changes and medications can’t stop the symptoms of GERD, surgery may be necessary. The most common surgical treatment for GERD is a procedure called fundoplication. During this surgery, the upper part of your stomach (or fundus) is wrapped around the lower part of the esophagus. This prevents acid from backing up into your esophagus.⁹

Heartburn and GERD can be uncomfortable and potentially serious conditions. Understanding the differences between them can help you recognize your symptoms — and get the right treatment.