What is the difference between heartburn and acid reflux?

Recognizing the distinctions between heartburn, acid reflux, and reflux disease involves understanding the interactions between them.

Heartburn is a widespread digestive symptom in the United States, affecting more than 60 million Americans per month, the American College of Gastroenterology says.

Heartburn is not by itself a disease and it has nothing to do with the heart. Instead it’s an acid reflux symptom.

If acid reflux symptoms often occur, it may mean a person has a gastroesophageal reflux disease (GERD).

It may be difficult to distinguish between heartburn, acid reflux, and GERD, because they might all sound the same right now. Understanding the differences can however help a person find the right treatment.

Symptoms

The following symptoms can help to tell a person the difference between acid reflux, heartburn and GERD:

Symptoms of acid reflux

Acid reflux causes stomach acid to travel up the food pipe into the mouth.
Acid reflux causes stomach acid to travel up the food pipe into the mouth.

Gastroesophageal reflux, or GER, is sometimes called acid reflux. It happens when stomach acid travels up to the mouth of the food tubing.

This can occur when the muscle at the bottom of the food pipe is weak or loose which acts as a gateway to the stomach.

Heartburn is a feeling of pain in the chest or abdomen, and has nothing to do with the heart. People frequently feel heartburn behind the breastbone and after feeding. Sitting or lying down will make it worse.

Heartburn is the most common symptom of acid reflux, although it does not occur in all situations.

Acid reflux also causes the following symptoms:

  • bad br breath
  • nausea or vomiting
  • difficulty or pain when swallowing
  • breathing problems

Symptoms of GERD

GERD is the term used for reflux of persistent acid. The symptoms are the same but with GERD they occur more frequently.

If a person experiences acid reflux symptoms for a couple of weeks longer than twice a week, they may have GERD. The disease affects the U.S. population about 20 percent.

Causes

The stomach is designed to withstand the acidity. The food pipe is not and a person feels burning pain when acid rises into it.

The muscle which is called the lower esophageal sphincter at the end of the food shaft. For several reasons it can weaken or relax, and possibly cause acid reflux.

For example, high amounts of abdominal pressure can cause the sphincter to grow slack. For this cause, acid reflux is normal in overweight, obese or pregnant people.

Other causes of acid reflux involve:

  • smoking or regular exposure to secondhand smoke
  • alcohol consumption
  • a type of hernia called a hiatal hernia
  • eating large meals
  • eating late at night or just before bed
  • consuming high-fat or fried foods
  • acidic drinks, such as fruit juice

Various medications can also trigger acid reflux, including:

  • asthma medication
  • high blood pressure medication
  • antidepressants
  • antihistamines
  • pain relievers
  • sedatives

Heartburn vs. heart attack

A man with chest pain
Seek medical care immediately if chest pain accompanies shortness of breath and a squeezing feeling.

Chest pain and related symptoms are among the top reasons for visits to emergency departments in the U.S. Acid reflux is a common cause of chest pain, and this pain can easily be confused with that of a heart attack.

Because heartburn can spread to the neck, throat, and jaw, it may feel like a heart attack’s radiating chest pain.

There are a few ways to tell the heartburn difference from a heart attack. If the pain improves after a quick antacid or belch, or if a sour taste is present in the mouth, a person will most likely have heartburn.

A person with a heart attack often has a squeezing or pressure feeling and shortness of breath.

The American Heart Association advises that anyone who suspects they may have a heart attack should seek medical care as soon as possible because of the risk of a heart attack. This includes people who are unsure whether a heart is causing their chest pain.

Diagnosis

A doctor is a good starting place for a diagnosis of acid reflux or GERD.

Evaluations typically start with a few questions and a review of the medical history of the individual. The doctor may suggest changes in the diet or medication, as these may affect symptoms.

If the symptoms persist, especially any related to swallowing, the doctor may work to confirm a diagnosis with a gastroenterologist, surgeon or other healthcare professional.

Tests that can help diagnose GERD include:

  • Upper gastrointestinal (GI) endoscopy and biopsy. A doctor inserts a thin, tube-like camera down the food pipe to look inside the stomach and perhaps take a tissue sample.
  • Upper GI series. A doctor checks X-rays to see whether something inside the body, such as a hernia, is causing the acid reflux.
  • Esophageal pH and impedance monitoring. The doctor places a thin tube inside the food pipe for about 1 day to measure acid levels.
  • Bravo wireless esophageal pH monitoring. The doctor monitors acid levels using a small capsule inside the food pipe and a receiver outside the body.
  • Esophageal manometry. This allows the doctor to measure muscle contractions in the food pipe.

Complications

If a person is not receiving GERD care, this can lead to more serious complications including:

  • esophagitis, or inflammation of the food pipe
  • narrowing of the food pipe that causes trouble swallowing
  • respiratory problems, such as pneumonia or laryngitis
  • Barrett’s esophagus, a condition that causes cells in the food pipe to change. Without treatment, this can potentially lead to cancer.

Treatment and prevention

Antacids neutralize stomach acid and may reduce the symptoms of acid reflux.
Antacids neutralize stomach acid and may reduce the symptoms of acid reflux.

Acid reflux and GERD are treatable with medications, lifestyle changes, or both.

Some medications for acid reflux include:

  • Antacids, which neutralize stomach acid. Options include Tums, Rolaids, Pepto-Bismol, and Mylanta.
  • H2 blockers, which reduce acid production. Options include Pepcid, Zantac, Axid, and Tagamet.
  • Proton pump inhibitors, a group of longer-term prescription medications that can reduce stomach acid. Options include Nexium, Prevacid, and Prilosec.
  • Prokinetics, a type of prescription drug that helps to empty the stomach more quickly. Options include Reglan and Urecholine.

People with acid reflux or GERD, by taking steps to avoid causes, can control symptoms.

  • Start by avoiding some or all of the following:
  • fried and fatty foods
  • large meals
  • smoking
  • alcohol
  • coffee
  • tomatoes and tomato products
  • spicy food
  • peppermint
  • citrus fruits and juices

Weight loss can also help to reduce symptoms, as pressure on the food pipe reduces.

People also should try not to eat late at night or lie down shortly after eating.

In severe GERD cases, surgery can help strengthen the intestinal muscles.

Children and pregnancy

Acid reflux often occurs in children, adolescents and pregnant women.

With 17 to 45 percent of pregnancies, heartburn can occur. Luckily heartburn and acid reflux treatments over- the-counter tend to be safe to use during pregnancy.

According to the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition, about 10 percent of teenagers and pre-teens experience GERD.

For children with GERD the symptoms, diagnosis and treatments are similar to those for adults. Check with your pediatrician to find out more.

When to see a doctor

When acid reflux happens on a regular basis, use an antacid and if the first is unsuccessful try different types. Seek also to make changes in lifestyle, such as removing certain foods or drinks from the diet.

If after making those changes, the acid reflux still recur, it may be time to call the doctor.

While chest pain is often a sign of acid reflux or GERD, if it is more severe, do not hesitate to visit the doctor or emergency room.

The GERD signs often warrant urgent attention.

Someone experiencing any of the following should seek medical attention immediately:

  • regular, forceful vomiting
  • persistent upper body pain
  • difficulty breathing
  • difficulty swallowing

Outlook

A symptom and its cause is the connection between heartburn and acid reflux.

Heartburn is a painful, common problem which may affect the quality of life of an individual. A individual has to treat the underlying cause, which is the acid reflux, to remove it.

Treat acid reflux symptoms by avoiding the many potential triggers. This may develop into GERD if acid reflux goes unchecked or untreated.

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