Clearing up the Confusion: Heartburn, Acid Reflux and GERD Explained

Welcome to the wild and wacky world of digestive troubles! Are you tired of feeling the burn, but not sure if it's heartburn, acid reflux, or GERD? Don't worry, you're not alone. 

In this blog post, we’re going to explore the differences between the 3 to help you figure out which one you might be dealing with. So sit tight and let’s get started! 

Heartburn

Let’s start with heartburn!

It’s a common and usually harmless condition caused by stomach acid flowing back into the esophagus and irritating the nerves in the area, causing that burning sensation. The name comes from the fact that the pain is felt in the chest, leading people to think it may be related to the heart. This is why it's important to rule out any heart problems beforehand. 

Common symptoms include tightness in the chest, burning sensation in the throat, and chest pain felt behind the breastbone. 

Acid Reflux

Next up is Acid Reflux. You know that ring-like muscle that connects your esophagus and stomach? It's called the lower esophageal sphincter (LES) and it's got a pretty important job! 

When you eat, the LES tightens up to keep your food in the stomach where it belongs, but sometimes the LES relaxes, leading stomach acid and bile to sneak back up into the esophagus. This is acid reflux in a nutshell. 

Common symptoms include heartburn, irritation in the throat, regurgitation, and sour taste in the mouth. 

Several health conditions could be associated with acid reflux such as esophagitis and gastroparesis. It’s even common with people suffering from bulimia nervosa, due to the purging behaviors forcing stomach acid back up. Over time, this can cause significant damage to the esophagus, leading to a host of digestive issues. 

Acid reflux could be the result of: 

• Esophageal dysmotility: muscles in the esophagus do not contract properly. If you wake up in the morning with acid reflux, this could be one of the causes. 
• Hiatal Hernia (upper endoscope needed for diagnosis).
• LES relaxation as discussed earlier.
• Delayed gastric emptying: foods stay in the stomach longer than they should.
• Gut dysbiosis: imbalance in the gut microbiota. This is where I can help! If you have more digestive issues than just reflux, it may be contributing to the cause. 

Gastroesophageal Reflux Disease (GERD)

Acid reflux and GERD are caused by the same mechanism - a malfunctioning LES that allows stomach acid to flow back into the esophagus. The main difference between the two is that GERD is a chronic condition, occurring on a regular basis (typically more than twice a week) and often accompanied by inflammation in the esophagus. 

Heartburn, acid reflux and GERD share the same symptoms, in addition to damaged tooth enamel, difficulty swallowing and constant coughing specifically for GERD. 

Now let’s dig a little deeper into some of the  lifestyle & dietary changes  you can practice. 

First, there is a role for medication...

Most of the time, medications should be used on a short-term basis. For example, proton pump inhibitors (omeprazole, esomeprazole and pantoprazole) are very effective at healing the esophagus. They’re also diagnostic, because if you have acid reflux then you should experience at least partial clinical improvement with these medications. If you do not, then we need to consider the possibility that your symptoms are not in fact due to acid reflux. The problem I see too frequently is that people are prescribed a medication and are stuck taking it long-term when they may not have needed to. Many times, people are also not experiencing symptom relief with the medication. A referral to a dietitian specializing in gut health would be a great addition to treatment options. We can provide education, guidance and natural solutions for dealing with acid reflux. 

 There are some lifestyle changes you can adopt to alleviate your symptoms:

• Listen to your fullness cues and stop eating when you feel 80% full.
• Limit intake of fat as it delays stomach emptying.
• Avoid carbonated drinks as they put pressure on the LES. Yes, that includes bubbly!
• Walk walk walk! It DRASTICALLY supports your digestive system. It’s best to walk after your meal, but I realize it’s not realistic to walk after every meal, so walk when you can!
• Some breathing techniques might help such as Diaphragmatic Breathing.
• Certain teas like ginger and chamomile may help acid reflux.
• Remain upright after meals.
• Allow 3-4 hours between the last thing you eat and your bedtime.
• Try elevating the head of your bed to keep your body in the optimal position for digestion even as you sleep. 
• Fix your gut! Damage to the microbiome could be causing your acid reflux. 

Some common dietary food triggers of acid reflux:

• Tomato sauce and other tomato-based products
• Citrus fruit juices
• High-fat foods, such as fast foods, greasy foods, and fried foods
• Garlic
• Onions
• Peppermint
• Alcohol
• Soda, coffee, caffeine
• Chocolate

Keeping a food log can help you identify how often you are eating the above foods and if it is contributing to the worsening of your symptoms. You may not need to remove all foods, but limiting them to your tolerance will be helpful. Doing as many of the above recommendations as possible is better than just trying 1 or 2. 

There are also supplements that are evidenced-based to help reflux, but I don't want to give those out without a proper nutrition assessment.

You can apply to work with me if you're struggling with your overall digestion and need more guidance! 

Bottom line: Heartburn, acid reflux and GERD can be confusing and often used interchangeably, but by understanding the distinctions between them, you can better manage your symptoms and get the relief you need. 

Remember to refer to your doctor for a proper diagnosis and you can refer to me for a proper nutrition protocol & help improving your gut health to enjoy a symptom-free life!