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DEAR MAYO CLINIC: How do I know if what I have is acid reflux or GERD? Are treatments the same for both? I've had what I would describe as heartburn for years and it's getting worse as I age.
ANSWER: Acid reflux happens when stomach acid flows back up into your esophagus -- the tube that connects your throat to your stomach. With acid reflux, you may get a taste of food or sour liquid at the back of your mouth, feel chest pain or pressure, or get a burning sensation in your chest. That sensation is called heartburn.
When acid reflux leads to frequent symptoms or complications, then it's called gastroesophageal reflux disease, or GERD. GERD usually requires treatment. If you have reflux symptoms more than twice a month, see your doctor to have your condition evaluated.
Occasional acid reflux is very common. Almost everyone experiences it from time to time. Acid reflux starts to become a problem when it happens frequently, involves large amounts of acid, or affects the part of your esophagus closest to your throat.
GERD is a more severe form of acid reflux. The most common symptom of GERD is frequent heartburn. Other signs and symptoms may include regurgitation of food or sour liquid, difficulty swallowing, coughing, wheezing and chest pain -- especially while lying down at night.
If reflux is only occasionally bothersome, or if it's mild, over-the-counter medications that control symptoms may be all you need. These include antacids that neutralize stomach acid, and drugs that decrease acid production by the stomach, called proton pump inhibitors and H-2-receptor blockers.
In some cases, lifestyle changes can help control the symptoms of reflux. Eat smaller meals and avoid foods you know cause heartburn or other symptoms for you. Stay upright after a meal, as lying down can often trigger symptoms. Don't smoke. If you're overweight, strive to get to a healthy weight. Extra pounds can put pressure on your abdomen, pushing up your stomach and causing acid to back up into your esophagus.
If over-the-counter medications and lifestyle changes are not enough to relieve your symptoms, if symptoms become more severe, or if they occur more than twice a month, then it's time to see your doctor. He or she may recommend prescription-strength medications to control reflux.
Most of the time, acid reflux can be effectively managed with medications. In more severe cases of GERD, when medications are not enough, surgery may be an option. Depending on the situation, a number of different procedures can be used that may prevent stomach acid from entering the esophagus.
It is important to have acid reflux that is causing symptoms evaluated and treated. If left untreated, frequent acid reflux or GERD can cause chronic inflammation in your esophagus. That may lead to a condition known as Barrett's esophagus.
In Barrett's esophagus, the color and composition of the tissue lining the lower esophagus change. These changes are associated with an increased risk of esophageal cancer. If you develop Barrett's esophagus, your doctor will likely check your esophagus regularly to look for early signs of esophageal cancer.
In most cases, however, acid reflux and GERD can be successfully treated before they damage the esophagus. Make an appointment to talk to your doctor about your symptoms and to discuss a treatment plan that fits your situation. -- Jeffery Alexander, M.D., Gastroenterology, Mayo Clinic, Rochester, Minn.
(Medical Edge from Mayo Clinic is an educational resource and doesn't replace regular medical care. To submit a question, write to: firstname.lastname@example.org. For health information, visit www.mayoclinic.com.)