What is acid reflux?
Acid reflux is a chronic condition, meaning it comes and goes with time and is difficult to cure completely. When stomach acid makes its way into your esophagus, the tube that links your mouth and stomach, this is acid reflux.
Depending on how intense your reflux is, you could experience this multiple times a week, have long episodes of reflux, and start to feel like your esophagus is constantly irritated. As periods of reflux get longer and more frequent, the esophagus becomes more and more damaged.
Even though GERD is a common issue, many don't recognize that they have it. In these situations, it goes untreated and can result in serious complications.
Mild acid reflux
This is the first stage of gastroesophageal reflux disease. If you have GERD, it's likely that you have this kind. With mild acid reflux, the lower part of your esophagus will be mildly inflamed.
If you have stage 1 acid reflux, you might experience:
At this stage, treatment mostly revolves around making lifestyle choices that fight reflux. You can avoid the symptoms above if you don’t consume irritating food and drinks, like coffee, alcohol, spicy foods, and fatty foods. In addition to keeping a healthy diet, you can buy over-the-counter antacids and stop eating at least three hours before you go to bed. If you try these things and you still have symptoms of GERD at night, you can try raising your head with extra pillows while you sleep.
Moderate acid reflux
About a third of people with acid reflux fall into stage 2. The main difference between mild and moderate acid reflux is that your symptoms will happen multiple times a week, resulting in more irritation and inflammation in your esophagus.
Moderate GERD, if you don’t treat it, can affect your day-to-day activities. You’ll likely need to take acid-suppressive medicines daily.
The symptoms of moderate GERD are similar to stage 1 GERD:
- Pain in your chest
- Feeling a lump in the back of your throat
- Regurgitating food and liquid
Although the symptoms are similar to less serious cases of acid reflux, they’re not so easily controlled. Over-the-counter solutions won’t be as effective. Ask your healthcare provider about antisecretory therapy via proton pump inhibitors or histamine 2 receptor blockers. You’ll need a prescription for both of these treatments. At this point in your reflux journey, you may want to start seeing a specialist who can help you mitigate these more intense symptoms.
Severe acid reflux
If you have stage three acid reflux, you’re probably already taking prescription medication and dealing with extreme symptoms every day. It’s likely that you’ll have erosive esophageal inflammation.
About 15% of people with acid reflux fall into this third stage.
If you have severe acid reflux, you might experience:
You need medication to control your reflux at this stage. You’re at high risk for developing serious complications. If you haven’t already found a reflux specialist, now is the time to do so. At their recommendation, you might undergo thorough testing in order to make sure your treatment is correct.
After many years of untreated stage three acid reflux, you could develop precancerous lesions or esophageal cancer. Around 10% of people who have GERD for a long period of time make it to this type of acid reflux. Also known as Barrett’s esophagus, this condition can turn into cancer if it remains untreated.
If you have stage four reflux, you might have:
- Regurgitate food and liquid
- Sore throat
- Coughing that doesn’t get better
- Food getting stuck in your esophagus while you eat
During stage four of GERD, a reflux specialist will perform tests and conduct surveillance to determine if you have a precancerous condition or cancer. You might have to undergo surgery or cancer treatments.
Finding the right treatment
In order to properly treat your acid reflux type, you need to know how severe your case is. Work with your healthcare provider to establish a plan for treatment that properly aligns with the stage of GERD you have. Remember that you might never be completely free of symptoms, but you can take measures to manage them.
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Advanced Internal Medicine: "Let's Talk About GERD (Acid Reflux)."
Cooper University Health Care: "The Stages of GERD."
Houston Heartburn & Reflux Center: "The Four Stages of GERD and Treatment Options."
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Heartburn vs. Acid Reflux (Differences and Similarities)
Heartburn and acid reflux are not the same thing. Heartburn is actually a symptom of acid reflux. Heartburn gets its name because it feels like a burning sensation around the heart. Another symptom that occurs with heartburn is a bitter or sour taste in the mouth, usually when you eat or lye down. Heartburn affects more than 60 million people in the US at least once a month. Acid reflux, or GERD, occurs when stomach acid backs up into the esophagus, which irritates it. Heartburn is just one symptom of acid reflux. Other symptoms of acid reflux include:
- Nausea after eating
- A feeling of fullness during or after eating
- Abdominal bloating
- Upset stomach
- Reflux laryngitis
- A tightness in the throat
- Problems swallowing
- In some people, vomiting
Causes of acid reflux and heartburn include:
- Being obese
- Slouching (poor posture)
- Medications like calcium channel blockers, theophylline, nitrates, and antihistamines
- Foods and drinks like caffeine, citrus fruits and vegetables, alcohol, and chocolate
- Increase in stomach acid
- Eating a heavy meal
- Eating before bed
The treatment for heartburn and acid reflux is to treat the underlying cause, for example, GERD, with over-the-counter (OTC) medicine, prescription medicine, natural remedies, and lifestyle changes like a eating a healthy, less fatty, spicy diet, not eating big meals, not eating before bed, and getting regular exercise to improve your posture.
Sometimes a heart attack can mimic heartburn and acid reflux because they feel very similar. If you have symptoms of chest pain, tightness in the chest, heartburn, acid reflux, jaw, tooth, or head pain; shortness of breath, nausea, vomiting, sweating, discomfort in the upper middle of the abdomen, arm or upper back pain, or the general feeling of being ill, go to the nearest Emergency Department immediately because these are the symptoms of a heart attack.
American College of Gastroenterology. "Acid Reflux." 2017.
familydoctor.org. "Heartburn." Updated: Mar 2014.
National Library of Medicine; PubMed Health. "Heartburn and GERD: Treatment options for GERD." Updated: Nov 18, 2015.
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