Heartburn vs. Acid Reflux

Written by Tricia Kinman | Published on November 4, 2014
Medically Reviewed by Brenda B. Spriggs, MD, MPH, MBA on November 4, 2014

The Difference Between Heartburn, GERD, and Acid Reflux

The terms heartburn, GERD, and acid reflux are often used interchangeably. However, they actually have very different meanings.

Acid reflux is a very common medical condition that may or may not be serious.

Gastroesophageal reflux disease (GERD) is the chronic, more severe form of acid reflux.

Heartburnis a symptom of GERD and acid reflux.

What Is Heartburn?

Heartburn is a mild to severe pain in the chest. It usually occurs after eating a meal. It can be a burning or tightening sensation. Bending over or lying down can make it feel worse.

The term “heartburn” is somewhat misleading. The heart actually has nothing to do with the pain. Heartburn occurs in your digestive system. Specifically, it occurs in the esophagus. It’s sometimes mistaken for heart attack pain. 

Heartburn is quite common. According to the American College of Gastroenterology (ACG), more than 60 million Americans experience heartburn at least once a month.

You may be able to manage your heartburn by:

  • losing weight
  • stopping smoking
  • eating fewer fatty foods
  • avoiding spicy or acidic foods

Mild, infrequent heartburn can also be treated with medications like antacids. However, a doctor should evaluate you if you take antacids more than several times a week. Your heartburn may be a symptom of a more severe problem like acid reflux of GERD. 

What Is Acid Reflux?

A circular muscle called the lower esophageal sphincter (LES) lies between your esophagus and stomach. This muscle is in charge of closing your esophagus after food passes to the stomach. If this muscle is weak or doesn’t close properly, the acid from your stomach can move backward into your esophagus. This is known as acid reflux.

The lining of your esophagus is more delicate than the lining of your stomach. Therefore, acid in your esophagus causes a burning sensation in your chest. This sensation is known as heartburn.

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 swelling in the esophagus. Pain from GERD may not be relieved with antacids or other over-the-counter medication.

Symptoms of GERD include:

  • heartburn
  • feeling like stomach contents have come back up to the throat or mouth (regurgitation)
  • chest pain
  • dry cough
  • asthma
  • trouble swallowing

Symptoms of GERD may disrupt your daily life. Fortunately, they can usually be controlled with treatment. Options include both medications and lifestyle changes like:

  • diet modification
  • weight loss
  • smoking cessation

Medications for GERD generally try to reduce the amount of acid in the stomach. They may not be effective for all patients. Some people need surgery to help strengthen the LES.

Consequences of GERD

Acid from the stomach can damage the lining of the esophagus if GERD is left untreated. This can cause:

  • bleeding
  • ulcers
  • scarring

The acid can also cause a change in the cells in the esophagus over time. This is called Barrett’s esophagus. Barrett’s esophagus increases your risk of esophageal cancer. However, esophageal cancer is extremely rare, even in people with Barrett’s. 

When Does Heartburn Require Medical Care?

Not all heartburn requires medical care. Infrequent and mild heartburn can be treated with antacids and lifestyle changes like avoiding spicy foods. Occasional reflux is not a cause for concern. You should consult a doctor if you have heartburn two or more times a week or if over-the-counter medications don’t relieve your discomfort.

Symptoms of heartburn are often mistaken for heart attack, but the two conditions are unrelated. If your heartburn discomfort and chest pain changes or gets worse and is accompanied by difficulty breathing or pain in your arm or jaw, call 911 immediately These symptoms can be signs of a heart attack.

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