Acid Reflux, Heartburn, and GERD: What's the Difference?

These terms are often used interchangeably, but are they really the same thing?

by Sara Suchy Editor

Heartburn, acid reflux, and gastroesophageal reflux disease (GERD) are all different terms to describe similar issues. However, the terms are usually used to specify severity and frequency of the symptoms, though they are often confused and misused. Let’s clear things up, shall we?

What is heartburn?

Heartburn usually describes a burning sensation felt in the chest, though the term itself is misleading; heartburn has absolutely nothing to do with the heart. A person experiences heartburn when stomach acid is allowed back into the esophagus.

Acid reflux: What causes heartburn?

Just like a car going the wrong way in traffic, food and stomach acid traveling the wrong way in the esophagus causes problems. This is when acid reflux occurs, according to the National Institutes of Health (NIH). When stomach acid and sometimes food are allowed back in the esophagus, it causes the burning, painful irritation, or the symptom commonly known as "heartburn."

This usually happens when the lower esophageal sphincter (LES) is under too much pressure, is weakened, or malfunctions all together. The LES connects the base of the esophagus to the stomach and is responsible for allowing solids and liquids into the stomach and keeping them from moving in the opposite direction.

But what actually causes heartburn? According to the NIH, mild to moderate heartburn can often be traced to:

  • Certain medications

  • Eating too much

  • Exercising after eating

  • Eating trigger foods, such as spicy or acidic foods

  • Eating too close to bedtime

Most people experience acid reflux every now and then, according to the NIH. The good news? In these cases, most people will be able to deal with the discomfort by taking a few antacids and avoiding the behavior that brought it on.

How are heartburn and reflux different from GERD?

GERD is a more serious form of acid reflux that lasts a long time, according to the NIH. GERD happens when the LES is weakened and malfunctions consistently, and not just when a person overeats or gulps down their food. If the LES cannot close completely after food empties into the stomach, acid backs up into the esophagus on a fairly regular basis, and not just when too much food enters the stomach too quickly.

Any numberof factors can cause GERD, both lifestyle and physiological. Some people will develop GERD as a result of being overweight or obese, which puts too much stress on the LES, according to the NIH. Pregnancy can also cause this.

Certain medications, smoking, and hiatal hernias are also causes of GERD.

What kind of damage can GERD do?

Having stomach acid where it’s not supposed to be can cause all kinds of problems beyond burning pain, according to the NIH. If the esophagus and the rest of the upper digestive tract is consistently saturated in acid, it can lead to:

  • Erosive esophagitis (erosion of the esophagus)

  • Severe narrowing (stricture) of the esophagus

  • Barrett’s esophagus (precancer of the esophagus)

  • Problems with teeth, throat, and airway leading to the lungs

How are heartburn and GERD different?

A bout or two of heartburn every once in a while is probably not going to cause too much harm. But when heartburn and reflux are a bigger problem, it can become GERD. If you experience heartburn several times a week, you should talk to your doctor.

If persistent heartburn becomes a problem, it’s best to keep a journal of your symptoms. The journal should note:

  • Severity of heartburn

  • When it starts and how long it lasts

  • Food eaten that day (try to pinpoint which foods may have caused the heartburn)

  • Any physical activities

  • Medications you’re taking

The more information about your symptoms that you provide your doctor, the better you can be diagnosed and treated.

Can heartburn ever involve my heart?

No, but that doesn’t not mean you should ignore frequent chest pain under any circumstances. It could be caused by other conditions that can harm your heart. For example, people who have had heart attacks often describe their first symptoms as "really bad heartburn."

Sara Suchy
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Sara Suchy

Sara is a former editor for HealthCentral.