Acid reflux vs. GERD: What is the difference?

Share on Pinterest

The main difference between acid reflux and GERD is that acid reflux is a symptom, whereas GERD is a chronic condition.

Acid reflux occurs when the contents of the stomach move back into the esophagus. Many people experience acid reflux occasionally. But if acid reflux is persistent and frequent, it could indicate GERD.

People with GERD may experience acid reflux multiple times per week or every day. The reflux may also be more severe, causing acid to reach the mouth or the regurgitation of food.

Unlike occasional acid reflux, untreated GERD also carries a risk of complications, such as Barrett’s esophagus. Barrett’s esophagus occurs when the lining of the esophagus becomes damaged, and the body replaces the damaged tissue with cells that are similar to the lining of the intestines.

A person who experiences rare acid reflux, or reflux only incidental to another condition such as pregnancy, probably does not have GERD.

Heartburn is another name for acid reflux. It refers to the burning sensation in the chest that acid reflux can cause. Some people may not feel acid reflux itself and only experience this burning sensation. However, it is the product of reflux.

GERD often causes heartburn, along with other symptoms. Despite the name, heartburn does not actually affect the heart.

The symptoms of acid reflux include:

• a sensation of liquid traveling back into the esophagus or throat
• bloating and discomfort
• burning in the chest
• a sour taste in the mouth
• bad breath
• nausea

People with GERD can experience these symptoms, as well as others that result from having frequent acid reflux, such as:

• a dry cough
• sore throat
• new or worsened asthma
• a feeling that there is a lump in the throat
• difficulty swallowing

The diagnostic criteria for GERD are not precise, so there is no hard rule for when acid reflux becomes GERD. Some factors that can help distinguish one from the other include:

• Frequency: Doctors often diagnose GERD when a person regularly has acid reflux multiple times per week. In a 2021 study, the authors defined GERD as reflux that happens more than two times per week.
• Severity: When acid reflux is severe and regularly disrupts a person’s life, a person may have GERD.
• Other symptoms: When a person develops complications of frequent acid reflux, such as erosive esophagitis or esophageal strictures, they may have GERD. Both complications occur because of chronic injuries to the esophagus.

Doctors may be able to diagnose acid reflux or GERD based on a person’s symptoms. The frequency and severity may indicate whether a person has one or the other. The doctor may also perform tests to rule out other explanations, such as:

• infections
• stomach ulcers
• food intolerances
• pregnancy

This may involve:

• stool tests
• urine tests
• blood tests
• breath tests

There is no single test that can confirm GERD itself. A doctor may determine the diagnosis by prescribing proton pump inhibitor (PPI) therapy. These drugs reduce stomach acid production. If they work, a person may have GERD.

Sometimes, GERD does not respond to treatment. If this occurs, a doctor may recommend additional testing, such as an endoscopic scan of the esophagus. This involves inserting a long tube with a small camera on the end into the esophagus so a doctor can see inside the upper digestive tract.

For occasional acid reflux, people can try antacids. These are over-the-counter (OTC) medications that can reduce the acidity of the stomach’s contents, reducing symptoms.

Some people with more severe acid reflux take OTC PPIs, such as omeprazole, esomeprazole, or lansoprazole. However, people should discuss this with a doctor if they often feel the need to take these medications.

Treatment options for GERD include:

• PPIs
• H2 blockers
• medical procedures to repair the sphincter that keeps stomach acid out of the esophagus
• surgery to help with weight loss, as obesity can cause or contribute to reflux

If a medication could be causing acid reflux as a side effect, a doctor may also suggest adjusting the dose or trying an alternative.

For people with mild symptoms, some simple adjustments to diet or lifestyle may reduce how often acid reflux occurs, without the need for medication.

Some common triggers for acid reflux include:

• caffeine
• alcohol
• high fat foods
• spicy, acidic, or minty foods

Dietary and lifestyle changes can also be important tools for managing GERD. It may help to try:

• reducing or eliminating alcohol and caffeine
• keeping a food and symptom diary to see whether certain foods trigger symptoms
• avoiding common trigger foods
• eating meals at least 3 hours before sleep
• reaching or maintaining a moderate weight
• sleeping with the head slightly elevated
• quitting smoking, if relevant

A person should contact a doctor if they experience persistent acid reflux, as this could be a sign of GERD or another underlying condition.

Seek professional advice if:

• acid reflux occurs regularly
• acid reflux is severe and disrupts daily life
• OTC acid reflux treatments do not work
• a person has other symptoms, such as difficulty swallowing or worsened asthma

People should consult a doctor as soon as possible if they have:

• persistent vomiting
• unexplained or sudden weight loss
• vomit that contains blood, which may look like coffee grounds
• bloody or black stool

Acid reflux is a symptom of indigestion that many people experience occasionally. Certain health conditions, medications, and pregnancy can trigger acid reflux. People can reduce their discomfort with OTC antacids and diet or lifestyle modifications.

If acid reflux is frequent or severe or undermines a person’s quality of life, they may have GERD. A person who thinks they may have GERD should seek medical treatment, since GERD can cause serious complications without treatment.