Heartburn vs. Acid Reflux: How to Tell the Difference

Acid reflux occurs when stomach acid backs up into the esophagus irritating the tissue.

Heartburn, or acid indigestion, is a symptom of acid reflux, so named because the esophagus lies just behind the heart, and that is where the burning sensation is felt.

Heartburn is a symptom of acid reflux. Heartburn describes a feeling of burning, pain, or discomfort in the chest that can be quite uncomfortable. You also may a sour or bitter taste in the throat and mouth, and it usually occurs after you eat a big meal or when you lay down.

Not everyone with GERD will experience heartburn. Other symptoms of acid reflux include regurgitation of acid into the throat or mouth, a bitter taste in the mouth, upset stomach, belching, nausea after eating, feeling full, stomach and upper abdomen bloating, dry cough, wheezing, hoarseness, feeling of tightness in the throat, and in some people, vomiting.

Heartburn, a symptom of acid reflux, and feels like a burning pain or discomfort in the chest, around the area of the heart.

Acid reflux may include heartburn symptoms. Other common symptoms of acid reflux include:

• A warm or acidic taste at the back of the throat
• Sore throat
• Upset stomach (dyspepsia)
• Abdominal pain or discomfort
• Nausea, a feeling of fullness
• Bloating
• Feeling tightness in the throat
• It may feel difficult to swallow, or you may feel like you have food stuck in your throat.

Acid reflux (GERD) and heartburn may cause chest pain, when after eating or when lying down. See your doctor if you have any chest pain that is not diagnosed because chest pain may be a sign of a heart attack or another serious heart condition.

If you have been diagnosed as having acid reflux by your doctor or other health care professional, and your symptoms change suddenly or worsen acutely, seek medical care right away to make sure this chest pain is not associated with a heart attack or other serious medical conditions.

1. Drinking alcohol
2. Smoking
3. Obesity
4. Poor posture (slouching)
5. Certain medications (calcium channel blockers, theophylline, nitrates, antihistamines)
6. Certain foods (fatty and fried foods chocolate, garlic and onions, caffeinated drinks, acidic foods such as citrus fruits and tomatoes, spicy foods, mint)
7. Eating large meals
8. Eating too quickly
9. Eating before bedtime
10. Hiatal hernia
11. Pregnancy
12. Diabetes
13. Increase in stomach acid (from stress, Zollinger-Ellison syndrome, stomach tumors)
14. Weight gain

Foods that may cause or aggravate acid reflux and heartburn include:

1. Fried and fatty foods
2. Chocolate
3. Garlic and onions
4. Caffeinated beverages
5. Acidic foods such as citrus fruits and tomatoes
6. Spicy foods
7. Mint

A medical doctor can often diagnose GERD (gastroesophageal reflux disease) and heartburn by your description of the symptoms your experience.

You may see a gastroenterologist, a medical specialist in disorders of the gastrointestinal (GI) tract, who may order an upper GI series. This is a series of X-rays of the esophagus, stomach, and upper part of the intestine often used to rule out other health conditions. An upper GI endoscopy, where a flexible probe with a tiny camera at the end is passed down your throat to see the esophagus. This helps diagnose how severe your acid reflux is, and can also rule out other health complications.

If your symptoms are not clearly from acid reflux, your doctor may perform other tests to rule out important conditions like heart attack, ulcers, lung problems, esophagus problems, and gastritis.

• Avoid eating close to bedtime.
• Don’t lie down soon after eating.
• Don’t eat large meals. Eating smaller, more frequent meals throughout the day may make a difference.
• Avoid trigger foods that can aggravate symptoms such as fatty or greasy foods, chocolate, caffeine, mint, spicy foods, citrus, and tomato-based foods.
• Avoid alcohol.
• Don’t smoke.
• Lose weight, if overweight.
• Maintain good posture.
• Talk to your doctor if you take any medications that may cause symptoms of acid reflux and heartburn to see if there are alternatives. Do not stop taking any prescribed medications without first consulting your doctor.
• Over-the-counter antacids (Maalox, Mylanta, Tums, and Gaviscon), or histamine-2 receptor blockers (H2 blockers) [cimetidine (Tagamet) and famotidine (Pepcid, Zantac 360)] may be used.

If diet and lifestyle changes and OTC medications don’t make a difference in relieving your condition, your doctor may prescribe medications to treat your reflux and heartburn such as:

• Proton pump inhibitors (PPIs): esomeprazole (Nexium), lansoprazole (Prevacid), rabeprazole (Aciphex), and pantoprazole (Protonix)
• Coating agents: sucralfate (Carafate)
• Promotility agents: metoclopramide (Reglan, Clopra, Maxolon) and bethanechol (Duvoid, Urabeth, Urecholine)

Most of the time, diet and lifestyle changes can help relieve or cure symptoms of acid reflux (GERD) and heartburn. In some cases over-the-counter or prescription drugs may be needed.

In rare cases, a last resort to cure acid reflux is a surgery called fundoplication. During this surgery, a surgeon wraps part of the stomach around the esophagus like a collar, which works to increase pressure in the lower esophagus to keep acid from backing up.