QUESTION: What is the difference between GERD and acid reflux? How can I get relief from symptoms?
ANSWER: First it’s important to understand what can cause heartburn. While there are a few conditions that can cause a burning sensation in the chest, the two conditions focused on in this post are acid reflux and gastrointestinal reflux disease (GERD).
GERD is a medical disorder affecting 20% of adults in North America. It is defined as symptoms or complications resulting from backflow of acidic stomach contents into esophagus and beyond. GERD is caused by a dysfunctional lower esophageal sphincter (LES), which is a ring of muscle at the junction of esophagus and stomach. Normally, the LES is closed except when we are eating or drinking to prevent stomach contents from traveling backwards. If the LES becomes too weak to close tightly or opens inappropriately, stomach acid can flow back into esophagus causing injury. This leads to GERD symptoms, one of which can be heartburn.
Episodic heartburn that occurs less than twice per week and is not painful is considered acid reflux, not GERD. However, both acid reflux and GERD symptoms can have a significant impact on quality of life.
Q: What are the symptoms of GERD?
- Consistent burning sensation in chest (heartburn) after eating or worsens when lying down
- Regurgitation of food or sour liquid from stomach
- Chest pain or pressure
- Pain with swallowing
Q: What are the risk factors?
The risk factors are closely related to non-drug treatments. It is important to identify triggers in order to alleviate the symptoms and to prevent further acid reflux episodes.
- Large meals
- Eating late at night
- Fatty or fried foods
- Full-fat dairy products, bacon, potato chips, fatty meats
- Acidic foods
- Grapefruits, oranges, lemons, limes, tomatoes, pineapple, tomato sauce
- Spicy foods
- Medications: NSAIDs (aspirin, ibuprofen, naproxen), opioids
Q: What steps can I take to relieve my symptoms?
One of the most effective treatments for acid reflux and GERD is making lifestyle changes to minimize symptoms and prevent future complications. Changes can include:
- Maintain a healthy weight
- Excessive weight or pressure on abdomen can increase the likelihood of opening and weakening LES
- Stop smoking
- Smoking relaxes the LES muscle, which can cause it to open inappropriately
- Elevate the head of your bed by 6 to 8 inches
- Let gravity help to keep the stomach contents in the stomach and prevent backflow
- Do not lie down after a meal for at least 2 to 3 hours
- Give your body enough time to digest your food and to empty stomach contents
- Eat slowly
- Prevents you from eating a large meal which can cause bloating and increase the likelihood of opening the LES
- Avoid food triggers
- Certain foods can exacerbate symptoms by slowing the movement of food out of your stomach or contributing to the stomach acidity
- Avoid NSAIDs if you have history of stomach ulcers or if you struggle with acid reflux symptoms. If you need something to take for pain or fever, you can consider acetaminophen (Tylenol®) instead
- NSAIDs are direct stomach irritants and they increase your risk of developing stomach ulcers. d click here:
While lifestyle factors should be addressed first, combining the use of a medication with lifestyle changes is very effective. Self-management of acid reflux symptoms by using over-the-counter (OTC) products is appropriate to control mild and intermittent symptoms. However patients must seek immediate medical attention if you experience any of following warning signs:
- Unexpected weight loss
- Severe pain
- Blood in stool or vomit
- Recurrent vomiting
- History of cancer
- New onset of symptoms in those older than 50 years of age
There are a variety of medications available over the counter. Due to the variety of options it’s important to consult with your pharmacist or physician for the most appropriate option for you. Self-treatment with an OTC is limited to two weeks. If your symptoms persist or worsen after two weeks, contact your doctor for further evaluation.
Lastly if you have any questions about a specific medication or family of medications feel free to submit your question to one of our clinical pharmacists.