What's the Difference between Acid Reflux And GERD?
Are you feeling a burning sensation in your upper chest or shoulders? If you're thinking heartburn, you're probably right. "Heartburn is the manifestation - the symptom - of acid reflux, or stomach contents coming back up in your esophagus," says Matilda Hagan, MD, a gastroenterologist and co-medical director of the Center for Inflammatory Bowel and Colorectal Diseases at Mercy Medical Center in Baltimore.
The cause can be easily identified (that 5-alarm chili perhaps). ), but if heartburn happens often - defined as a couple of times a week - it could be a symptom of a more serious condition called gastroesophageal reflux disease (GERD).
While it may seem that GERD is just a fancy name for heartburn, they are more like close cousins than identical twins.
What is heartburn? When you swallow food, the acid travels down your esophagus to the stomach. There, a ring made of muscle called the lower esophageal sphincter or (LES) closes. This allows the food inside. The LES can sometimes be weak and not properly closed. This allows stomach acid to back-up, which causes irritation of the lining. This is acid reflux or heartburn.
Heartburn is a common condition in America, with more than 60,000,000 Americans experiencing it at least once every month according to the National Institutes of Health. Some symptoms include:
You may feel a burning sensation in your center that lasts for several minutes or an hour. You can avoid heartburn with the following lifestyle adjustments.
Reflux-triggering foods should be avoided. Acidic, spicy and fried foods as well as fatty foods can trigger reflux. Caffeine and alcohol can also trigger reflux. For optimal digestion, keep your head up after eating. Dr. Hagan advises that it is best to avoid eating in the hours before bed. Losing weight is an option if you are overweight. Obesity can cause the weakness of the lower esophageal. Do not smoke. When Acid Reflux Is Chronic: What Is GERD? According to the American College of Gastroenterology, GERD is acid reflux that occurs two or more times per week. It is estimated that up to 20 percent of the U.S. population has GERD.
That said, it's not the case that a person who has occasional heartburn will necessarily progress toward having GERD, says Louis Cohen, MD, gastroenterologist and assistant professor of medicine at the Icahn School of Medicine at Mount Sinai Hospital in New York City. The symptoms of acid reflux are similar to those experienced with heartburn, including the burning sensations in the chest or the feeling that the contents of your stomach are trapped in your throat. Dry coughs and trouble swallowing may be signs of acid reflux.
The primary care doctor or gastroenterologist can typically diagnose the condition simply by looking at the severity and frequency of symptoms.
Dr. Cohen says, "We might also place a probe in a patient’s esophagus to determine how often reflux occurs." Beyond evaluating symptoms, knowing how frequently reflux happens is another method to confirm the diagnosis.
Treatment for GERD starts with lifestyle modifications, adds Hagan: "We'll ask patients to try these steps before we offer medication, although we understand that it can be hard to do some things, such as quitting smoking."
According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), the most effective medication to treat GERD is a proton pump inhibitor (PPI), such as:
Prevacid (lansoprazole) Nexium (esomeprazole) Prilosec (omeprazole) PPIs work by decreasing the amount of acid your stomach produces, which allows the esophageal lining to heal in the majority of people with GERD. These medications can be purchased over-the counter or prescribed by your doctor. Although they are safe and effective, side effects like headaches, stomach upset, diarrhea, etc. may occur. The NIDDK report suggests some evidence that PPIs could increase the risk of Clostridioides diff infection, also known as C. diff. The effects of PPIs in high dosages or long-term use are still being investigated. Talk to your doctor about the benefits and risks.
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Hagan says that H2 blocking drugs such as Pepcid (famotidine) and Zantac(ranitidine), could also prove to be beneficial. They are also effective in reducing stomach acid production and can be purchased over-the-counter.
"If we determine that GERD symptoms are caused by hypersensitivity in the esophagus or excessive relaxation of the lower esophagus, we might prescribe tricyclic antidepressants or selective serotonin reuptake inhibitors," adds Cohen. A review of the July 2020 Journal of Internal Medicine research found that certain antidepressants have pain-modulating properties.
If patients are not able to take medication well or have difficulty swallowing it, then surgery might be an option. A number of surgical procedures to treat GERD are available that strengthen the barrier between the stomach and the esophagus. You will be guided by your gastroenterologist through all the available options, and will help you to choose which one is right for you.
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Delaying Treatment for GERD May Lead to Complications If GERD goes untreated, it can lead to more serious complications. Esophagitis refers to inflammation of the stomach and esophagus. Hagan states that you should seek treatment for esophagitis. This is an inflammation in the esophagus. It can cause esophageal pain, as well as a restriction of proper swallowing.
Another complication of GERD is a condition called Barrett's esophagus (BE). Hagan says that the stomach acid can cause cells in the linings of the esophagus over time to look more similar to the stomach lining. This cellular change may result in a rare form of esophageal carcinoma. The Mayo Clinic states that BE is more prevalent in the following areas:
According to the American Cancer Society, Esophageal Cancer is a relatively uncommon form of cancer. It accounts for just 1% of all diagnosed cancers in America. According to an article published in 2019, in Journal of Gastroenterology, the incidence of esophageal carcinoma (a type of esophageal tumor) has increased over the last few decades.
A January 2021 study in Cancer Epidemiology, Bimarkers & Prevention, a publication of the American Association for Cancer Research, revealed that this type of cancer is increasing in young adults. Between 1975 to 2015, the average incidence rate for esophageal adenocarcinoma rose by 2.9 percent annually.
Hogan suggests that if you are diagnosed with BE your doctor might recommend surveillance endoscopies. They will conduct an endoscopy each month, to check how the esophagus heals.
It comes down to this: If heartburn is a problem, consult your doctor to determine the root cause. If you learn to treat GERD with lifestyle changes or medication, you can avoid more serious complications.