Heartburn vs. Acid Reflux vs. GERD: Everything You Need to Know

Heartburn, acid reflux, and gastroesophageal reflux disease (GERD) are related, and the terms are often used interchangeably, but they are not the same.

Heartburn is a symptom of acid reflux that occurs when gastric juices back up from the stomach into the esophagus (food pipe), irritating the cells that line it. This can cause a burning sensation in the chest, which is where the term "heartburn" comes from. In addition to heartburn, acid reflux can cause you to develop symptoms such as a cough, bad breath, and trouble swallowing.

Repeated episodes of heartburn usually signal the presence of GERD. If left untreated, GERD can cause a number of medical complications such as throat cancer, Barrett’s esophagus, and inflammation of the esophagus (esophagitis). 

This article will discuss the similarities and differences among heartburn, acid reflux, and GERD.

The Breakdown

Heartburn is a symptom of acid reflux and GERD. Occasional acid reflux is not concerning and usually goes away on its own, but repeated bouts of GERD can have dangerous medical consequences and should be addressed immediately.

What Is Heartburn?

Symptoms

There is a wide range of heartburn triggers that may result in a variety of symptoms, including:

• Burning sensation in the chest: Irritation of the tissues in the esophagus results in an uncomfortable burning sensation in the chest, usually behind the breastbone. 
• Sore throat: Acid reflux can cause regurgitation and inflammation of the adenoids (tissues at the very back of the nasal cavity), resulting in a sore throat. 
• Sour or bitter taste in the mouth: The backflow of gastric contents can sometimes cause you to have an unpleasant taste in your mouth.
• Trouble swallowing: Also known as dysphagia, difficulty swallowing can occur when food does not pass normally from the mouth through the esophagus and to the stomach. Sometimes this can feel like a burning or choking sensation in the chest.
• Chronic coughing: A persistent cough is one of the most common symptoms that accompanies heartburn.

Causes

Heartburn is caused by a variety of conditions. In fact, anything that disrupts the esophagus can cause you to experience heartburn,This is why a proper medical evaluation of your symptoms is important.

Some of the mechanisms that can contribute to heartburn include direct irritation of the esophagus, weakness of the lower esophageal sphincter (LES), motility disorders of the digestive tract that result in delayed gastric emptying, and hiatal hernia (upper part of your stomach bulges through an opening in the diaphragm).

Treatment

If you have heartburn on occasion, it may be hard to determine the exact cause of your symptoms. It might help to think about the foods you ate, the activities you were doing, the clothes you were wearing, and the medications, if any, that you took prior to feeling your symptoms. 

Your treatment will depend on the cause. If the cause is a food that you ate, you might want to take an over-the-counter (OTC) medication like TUMS (antacid) or Pepto Bismol (bismuth subsalicylate) and avoid that food moving forward.

Loosening your clothes and not lying down after a meal may also help. If you were smoking or drinking excessively, the passing of time may be enough to resolve your symptoms. 

What Is Acid Reflux?

Symptoms

The symptoms of acid reflux are similar to heartburn. They include:

• Abdominal bloating
• Bad breath
• Dry cough
• Gas (burping)
• Heartburn (pain or burning sensation in the chest)
• Difficulty swallowing (dysphagia) or feeling like there is a lump in your throat
• Hiccups
• Nausea or vomiting
• Regurgitation (tasting food or stomach acid in the throat)
• Sore throat

Causes

Acid reflux is a digestive disorder that occurs when stomach contents back up into your esophagus. The most common cause of this is a weakening of the lower esophageal sphincter that allows food content and gastric juices to backflow and irritates the lining of your food pipe.

Acid reflux is usually triggered by certain foods, ingredients, or food groups such as caffeine, peppermint, fat or fried foods, chocolate, citrus fruits, and spicy foods, although smoking, drinking alcohol excessively, and laying down after you eat may also cause the lower esophageal sphincter to open, causing acid reflux and heartburn.

Treatment

Acid reflux is usually most effectively treated with a combination of lifestyle changes, prescription or OTC medication, and natural or herbal remedies.

If you have occasional acid reflux and you’re looking for relief, it is likely that over-the-counter medications and avoiding the trigger of your heartburn will likely do the trick. You may want to consult your healthcare provider on which type of acid reflux treatment to take, but generally, these are safe and have minimal side effects. Some of the medications that might be used include:

• Antacids that neutralize the acids in the stomach: Some name brands include Tums, Maalox, Rolaids, and Mylanta.
• Bismuth subsalicylate: The most popular brand is Pepto Bismol, which limits the flow of fluids and electrolytes into the intestines.
• Acid-reducing medication such as H2-receptor blockers: These work by reducing the amount of acid created in the stomach lining. They work quickly, often witihin 15 to 30 minutes, and the effects may last for about 12 hours. Examples are Axid AR (nizatidine), Tagamet (cimetidine), and Zantac 360 or Pepcid AC (famotidine).
• Proton pump inhibitors (PPIs): These are another potent acid-reducing medication, except their effects last longer than H2 inhibitors, producing relief for as long as 24 hours. The effect is increased when they’re taken for several days in a row. Some commonly sold PPIs are Nexium (esomeprazole), Prevacid (lansoprazole), and Prilosec (omeprazole).
  

The following natural remedies and lifestyle changes may also be helpful: 

• Take herbs such as ginger, chamomile, aloe juice, and licorice, which serve as a digestive aid.
• Combine a pinch of baking soda with water to create an alkaline solution that may help neutralize acid in the stomach.
• Like baking soda, taking a spoonful of apple cider vinegar with some water is thought to help neutralize acid in the stomach and serve as a digestive aid. 
• Chew sugar-free gum. Saliva production can provide a soothing effect and help decrease the production of acid in the stomach.
• Eat a banana (or another high alkaline food). Bananas are high in potassium, making them a fairly alkaline food. This means it is the perfect food to counter the stomach acid that is irritating your esophagus.
• Quit smoking. Smoking reduces saliva production, thereby increasing the production of stomach acid. 
• Never lie down after you eat , and wear loose-fitting clothing. Anything that pushes on the belly or interferes with keeping your food (and stomach acid) down can cause or worsen your heartburn. 
• Avoid trigger foods.
  

What Is GERD?

Symptoms

GERD symptoms are similar to heartburn and acid reflux symptoms, except with a few additional symptoms due to the chronic nature of the disease.

• Chest or abdominal pain (usually a burning sensation in the chest)
• Chronic dry cough
• Nausea or vomiting
• Bad breath
• Difficulty swallowing (dysphagia) or feeling like there is a lump in your throat
• Hoarseness
• Wheezing or other asthma-like symptoms (GERD can trigger asthma making it difficult to breathe)
• Difficulty sleeping

Causes

Repeated bouts of acid reflux result in GERD. Over time, damaged cells in the esophagus can cause narrowing of the esophagus, sores (ulcers), inflammation, and even permanent genetic changes to the cells that line it.

If left untreated, GERD can have serious medical consequences, including cancer, so it must be addressed immediately. 

Treatment

The frequency and severity of your symptoms will typically determine whether you need to make lifestyle changes, take medicines, or both to manage symptoms of GERD.

Your healthcare provider may recommend medication. These can include some of the same medications used for acid reflux:

• OTC antacids like Rolaids and TUMS, to neutralize stomach acid
• Acid blockers, like H2 blockers, which include OTC medications such as Zantac 360 or Pepcid AC, or prescription medications such as Tagamet or Tagamet-HB
• Proton pump inhibitors, such as Protonix (pantoprazole) and Prilosec (omeprazole). 

Knowing the risk factors that contribute to GERD and the triggers that cause exacerbations—like spicy foods, high caffeine intake, obesity, and smoking—can help you avoid GERD and reduce your need for medication.

If you have recurrent GERD, the following lifestyle changes may also reduce your symptoms and increase your quality of life: 

• Losing weight if you’re overweight or have obesity
• Elevating your head during sleep by placing a foam wedge or extra pillows under your head and upper back to incline your body and raise your head off your bed 6 to 8 inches
• Taking a walk after a meal to aid in digestion
• Quitting smoking 
• Changing your eating habits and diet

Prevention

An occasional bout of acid reflux is common and usually of little concern. Repeated bouts of acid reflux can signal GERD, a highly preventable condition that can be prevented with a combination of lifestyle modifications and medication. The following steps can prevent GERD:

• Lose weight: Extra abdominal fat places pressure on your abdomen, pushing gastric juices up into your esophagus.
• Avoid trigger foods: Spicy foods, onions, chocolate, caffeine, and junk food have all been shown to increase the prevalence of GERD.
• Don’t lie down after eating: Gravity is a major contributor to food digestion. When you lie down gravity is negated making it more likely for acid to backflow from the stomach through the esophageal sphincter and into the esophagus. 
• Eat food slowly and chew thoroughly: More food in the stomach can mean more acid buildup. Eating smaller meals and small portions can decrease acid reflux.
• Avoid tight-fitting clothing. 
• Quit smoking: Nicotine relaxes the esophageal sphincter allowing for acid to enter.
• Limit alcohol: Like smoking, alcohol can relax the LES.
• Elevate the head of your bed: Elevating your entire top half of your body, not just your head, 6 to 8 inches means that gravity is reintroduced, resolving backflow of stomach acid into the esophagus. 
• Avoid carbonated beverages. They make you burp and may bring acid up along with the gas. 

When to Talk to Your Healthcare Provider

Heartburn is common and usually goes away on its own, but if worrisome signs accompany your symptoms, persist for more than a few hours despite treatment, or cause you concern, do not ignore how heartburn feels.

If you experience any of the following symptoms, seek immediate medical attention to rule out more serious possible causes of your pain like a heart attack or pulmonary embolism:

• Squeezing or pressure sensation, especially pain that is worsening or radiating to the left side of the body
• Pain that travels to your jaw, neck, shoulders, arms, or back
• Shortness of breath
• Nausea or vomiting
• Light-headedness
• Loss of consciousness
• Sweating (especially profuse sweating in a cool area)
• Racing heartbeat

Summary

Heartburn, acid reflux, and GERD are terms that are often used interchangeably, but they are different. Heartburn is a symptom of acid reflux. GERD is a serious condition that is characterized by repeated bouts of acid reflux. All three can be managed, and in some cases cured, with a combination of medication and lifestyle changes.

A Word From Verywell

Acid reflux and GERD can both cause heartburn, but GERD, or repeated bouts of acid reflux, is a much more serious condition that must be addressed. Knowing the differences among the three is key to appropriately addressing your symptoms so that you can avoid potential complications down the line.