Gastroesophageal reflex (GER) happens when your stomach contents rise into your esophagus. It’s a minor condition that affects most people at one time or another.
Gastroesophageal reflex disease (GERD) is a more serious and persistent form of GER. It irritates your esophagus. If left untreated, it can result in serious health complications.
Distinguishing between GER and GERD can help you get proper treatment.
What Is GER?
Gastroesophageal reflux (GER) is also called acid reflux, acid indigestion, or heartburn. It occurs when acid from your stomach backs up into your esophagus. This causes a burning and tightening sensation in your chest and upper stomach area.
During normal swallowing, your esophagus muscle contracts to push food down into your stomach. Then, your esophagus muscle opens a valve called your lower esophageal sphincter (LES). This muscle appears at the entrance to your stomach and allows food to pass through. Once the food arrives in your stomach, your LES closes to prevent your digestive acids and other stomach contents from rising back up into your esophagus.
During periods of GER, your LES doesn’t remain closed like it should. This allows stomach acid to creep back up into your esophagus. It can result in irritation and burning in the lining of your esophagus.
GER is fairly common in infants who haven’t yet fully matured, as their LES muscle needs more time to develop. This is why babies typically spit up and burp after eating. However, GER can become serious if it lasts beyond the one-year mark. This can indicate that your baby has GERD.
GER or heartburn is also fairly common in adults. It’s especially common after eating large meals, foods that are hard to digest, or foods that increase stomach acids. These include fatty foods, spicy foods, and acidic fruits and juices.
What Is GERD?
Gastroesophageal reflux disease (GERD) is an official disease diagnosed by your doctor. Its main symptoms of heartburn and acid reflux are similar to GER. However, it’s a more serious condition that requires treatment to avoid more health complications.
If you have GERD, you may experience the following symptoms:
- frequent heartburn, more than two times a week
- chest pain
- regurgitation of partially digested food into the back of your throat
- trouble swallowing
- breathing difficulties similar to asthma
- sore throat
- a sour taste in the back of your mouth
Although the exact causes of GERD aren't always clear, they usually involve factors that weaken or overwhelm your LES. If you have GERD, your LES may have been injured or compromised in some way. As a result, certain triggers, such as eating a big meal or consuming acidic beverages, overpower your LES. When your LES gives way, acids are allowed to flow back into your esophagus.
When Does GER Become GERD?
If you have heartburn that occurs two times a week or more, and you experience other related symptoms, you may be diagnosed with GERD.
It’s important to note any changes that occur in your digestive habits. Are you starting to experience heartburn when you didn’t before? Do you find that you’re more sensitive to certain foods than you used to be? These may be natural effects of aging. However, if symptoms persist, it’s important to make an appointment with your doctor to avoid other potentially dangerous health conditions.
Almost anyone can experience GER after consuming a large meal or when lying down too quickly after eating. However, risk factors for GERD are typically more specific. They may include:
- injury or trauma to your esophagus
- connective tissue disorders that weaken your LES
- hiatal hernia
- alcohol use
- Zollinger-Ellison syndrome
- oral steroid therapy
- frequent use of NSAID’s (e.g., ibuprofen, naproxen)
Research also suggests that high rates of obesity may be leading to more cases of diagnosed GERD.
Stomach acid can gradually damage the cells and tissues in your esophagus. This can lead to the formation of scar tissue, which can make swallowing more difficult. Such damage can also lead to open sores in your esophagus, known as esophageal ulcers. It can even cause cancerous changes in the lining of your lower esophagus.
Complications of GERD can also include lung inflammation and infection, throat inflammation, and the collection of fluid in your sinuses and middle ear.
Lifestyle changes and medications can help you manage the symptoms of GERD.
For example, over-the-counter antacids may provide some relief. However, you may find that you’re taking them too often or they aren't effective. If your symptoms persist, your doctor may prescribe medications that reduce your body’s production of stomach acid and heal your esophagus. Medications such as calcium channel blockers (CCB) and nitrates may be helpful in certain situations.
Your doctor may also recommend lifestyle changes. For example, they may encourage you to:
- maintain a healthy weight
- avoid lying down after eating
- avoid foods that trigger your heartburn symptoms
- eat smaller meals
- quit smoking and the use of other nicotine-containing products
- avoid caffeine, chocolate, and alcohol
- stop or minimize the use of aspirin and other NSAID’s
If your symptoms are not well controlled with medication, your doctor may recommend surgery to reinforce or strengthen your LES.
Be sure to see your doctor if you have frequent episodes of acid reflux or other symptoms of GERD. The goal is to address the problem early, before more damage occurs. You can manage your GERD symptoms with medications and lifestyle changes.