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Acid reflux and GERD are related but different conditions. Acid reflux is something many people get occasionally, such as after a heavy meal or eating something that bugs your stomach. In contrast, GERD is the chronic (and often severe) form of acid reflux. Minor acid reflux is usually something that can be managed straightforwardly, while GERD often requires medical guidance.
Acid reflux happens when your stomach acid flows up into your esophagus and throat, where it doesn't belong. It can irritate both your esophagus and throat, and they may get inflamed. This is often due to a weakened lower esophageal sphincter, which is a muscular valve located in your esophagus that is meant to keep acid in the stomach.
Most people have experienced acid reflux at some point, and for many people it is an occasional thing that happens. Thankfully, while it might be annoying, it is usually not harmful.
GERD (gastroesophageal reflux disease) is essentially chronic acid reflux. GERD can have varying stages of severity, but an easy way to check if it might be chronic is if your acid reflux occurs at least twice a week for multiple weeks.
While acid reflux is almost always temporary, GERD rarely just goes away on it's own. With GERD, it means there is some sort of problem with your body's mechanisms.
Both acid reflux and GERD are common. Most researchers estimate GERD to affect about 20% of adults in the U.S. You are not alone in this, if this is what you are dealing with.
Symptoms of GERD and acid reflux can vary from light to severe, and may include:
• Heartburn or indigestion, caused by acid inflaming the tissues in your esophagus.
• Chest pain that doesn't feel like heartburn.
• Regurgitation, when acid or food backwashes from your stomach to your throat. This may also cause a sour taste in your mouth.
• Nausea
• A sore throat, usually caused by acid in your throat. Some people do not get a sore throat, but instead have a "lump in throat" feeling that they can't clear by coughing.
• Coughing or shortness of breath, often confused with asthma or allergies.
One annoying part about dealing with GERD or acid reflux is that they can present themselves at different times and because of different factors. You may notice them at night, after drinking alcohol, after eating too much, etc.
One of the main causes of acid reflux is a weak LES, the muscular valve mentioned previously that blocks acid from traveling up into the esophagus. However, if it relaxes or is weakened, acid can sneak through.
With acid reflux, this is usually temporary. However, having GERD means that his is happening more often, such as multiple times a week.
Since many different things can cause a weakened or relaxed LES, figuring out the cause can be a frustrating process for many. Acid reflux and GERD can come and go, minor acid reflux can sometimes turn into chronic GERD, and there are often different overlapping factors.
Common causes of GERD and acid reflux include:
• Foods and drinks like tomatoes, chocolate, mint, coffee, alcohol, and others that can cause the LES to relax. This is a popular cause of temporary reflux, but usually isn't the main cause of GERD (although foods can worsen symptoms).
• Stress, especially severe stress. Your gut and nervous system are connected, and stress can do things like cause your stomach to produce more acid, weaken the LES, slow stomach emptying, and disrupt your digestive system in other ways. Studies have shown that people with high levels of stress are more likely to develop GERD.
• Being overweight or obese, as both put pressure on the abdomen. This pressure can weaken the muscles that support the LES, causing it to weaken. Since obesity is usually not a short-term thing, it can cause the muscles to be weakened for longer or even permanently. Obesity can also often be the large part of developing a hiatal hernia.
• Smoking or vaping, as their outputs relax the LES and can also trigger coughing. Smoking has long been known to be a cause of GERD and acid reflux, and vaping has recently been studied to be a cause as well. Both smoking and vaping can disrupt normal digestion.
• Pregnancy, as similarly to being overweight, it puts more pressure on your abdomen. This in turn tends to weaken the LES. Along with abdominal pressure, pregnancy hormone like relaxin can cause the LES to relax, letting acid slip by.
• Having a hiatal hernia, which is when part of the stomach pushes into your diaphragm. This compresses the esophagus, which traps acid and causes the LES to further weaken. Hiatal hernias are relatively common, and can occur gradually as a person ages.
Apart from these, GERD and acid reflux can also be caused by other gut conditions, an H. pylori infection, certain medications, past surgeries, and past or current illnesses.
Temporary acid reflux is usually fine. However, severe acid reflux or GERD can lead to further complications. When stomach acid leaves the stomach, it can cause damage over time, as your other organs do not have the stomach's protection against acid.
GERD and acid reflux are not life-threatening by themselves, but they can affect your quality of life and lead to more serious health problems. Further complications of acid reflux tend to affect the esophagus, but can also impact your lungs if acid gets into the wrong place. They can include:
• Barrett's esophagus, which is when the tissues lining your esophagus change, and begin to resemble intestinal lining. Barrett's esophagus is usually caused by long exposure to acid, and is a risk factor for esophageal cancer.
• Esophagitis, which is when your esophagus' lining is inflamed. Having this long-term can cause things like ulcers and other negative changes.
• Laryngopharyngeal reflux (LPR), which is also called 'silent reflux'. LPR is reflux that goes all the way to your throat, and typically does not have the normal symptoms of GERD (such as heartburn). LPR can cause acid particles to get into your lungs, and also often leads to voice hoarseness and swelling.
• Esophageal stricture, which is an abnormal narrowing of the esophagus caused by scar tissue. This can make is harder to swallow.
• Asthma aggravation, if you already have asthma. Acid can get into and irritate your airways. This can also cause asthma-like symptoms in people who do not have asthma.
GERD is typically diagnosed by a gastroenterologist. It is a straightforward process, and the gastroenterologist may run one of several different tests to look at your esophagus:
• Upper endoscopy, which is when a camera is used to look inside your esophagus. The camera goes through the mouth while the patient is asleep.
• Esophagram, which is a type of X-ray that focuses on your esophagus.
• Esophageal pH test, which measures how often stomach acid enters your esophagus and how long it stays there. It involves using a thin tube or pH probe to measure the acid level inside of your esophagus.
• Esophageal manometry, which focuses on the muscle activity of your esophagus. It can test the pressure and contractions of the esophagus, and is usually done so through pressure sensors on a thin tube.
Some people can overcome their acid reflux through diet and lifestyle adjustments, while others (often those with GERD) usually need medications to relieve symptoms. Read more about treating acid reflux and GERD here.
