Is it Simple Heartburn or Is it GERD?

Nearly everyone has heartburn now and then. But heartburn is also the most common symptom of gastroesophageal reflux disease (GERD), so talk to your doctor if:

• Your heartburn happens 2 or more times a week
• Your heartburn gets worse
• Your heartburn happens at night and wakes you from sleep
• You’ve had heartburn now and then, but for several years
• You have difficulty or pain when swallowing
• Your discomfort or pain interferes with your daily activities

What Is GERD?

Gastroesophageal reflux disease, or GERD, is a digestive disorder that affects the ring of muscle between your esophagus and your stomach. This ring is called the lower esophageal sphincter (LES). If you have it, you may get heartburn or acid indigestion. Doctors think that some people may have it because of a condition called hiatal hernia. In most cases, you can ease your GERD symptoms through diet and lifestyle changes. But some people may need medication or surgery.

In normal digestion, your LES opens to allow food into your stomach. Then it closes to stop food and acidic stomach juices from flowing back into your esophagus. Gastroesophageal reflux happens when the LES is weak or relaxes when it shouldn’t. This lets the stomach's contents flow up into the esophagus.

Did you know – heartburn is not the only symptom of GERD

Chronic heartburn is the most common symptom of GERD. Acid regurgitation (refluxed material into the mouth) is another common symptom. But numerous less common symptoms other than heartburn may be associated with GERD. These may include:

• Belching
• Difficulty or pain when swallowing
• Waterbrash (sudden excess of saliva)
• Dysphagia (the sensation of food sticking in the esophagus)
• Chronic sore throat
• Laryngitis
• Inflammation of the gums
• Erosion of the enamel of the teeth
• Chronic irritation in the throat
• Hoarseness in the morning
• A sour taste
• Bad breath

Chest pain may indicate acid reflux. Nevertheless, this kind of pain or discomfort should prompt urgent medical evaluation. Possible heart conditions must always be excluded first.

Relief of symptoms after a two-week trial therapy with a proton pump inhibitor (a prescription medication that inhibits gastric acid secretion) is an indication that GERD is the cause. This can also be confirmed with pH monitoring, which measures the level of acid refluxing into the esophagus and as high as the larynx.

Ref:International Foundation for Gastrointestinal Disorders,  The Journal of teh American Medical Association:"Gastroesphageal Reflux Disease."  American College of Gastroenterology:"Understanding GERD"

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