The Difference Between GERD and Heartburn

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GERD - Overview

Gastroesophageal Reflux Disease is a chronic condition, whereas acid reflux (or heartburn) is a relatively mild ailment.

The major difference between the two is the severity and frequency of attacks.

Ordinary heartburn rarely causes long-term medical issues.

However, untreated GERD can cause major medical problems leading to life-threatening consequences.


The Mechanics of Acid Reflux

Digestive juices create havoc when they escape from the stomach.

These fluids are a mixture of hydrochloric acid, pepsin (a digestive enzyme) and bile.

Although the stomach lining is impervious to this corrosive mixture, the lining of the food pipe is not.

There is a valve situated at the junction between the esophagus (food pipe) and the stomach, called the lower esophageal sphincter (LES).

The main purpose of the LES is to prevent corrosive gastric fluids escaping from the stomach and attacking the unprotected lining of the food pipe.

Its secondary function is to allow food to pass into the stomach while at the same time, preventing the upward reflux of acids.


Common Causes of Heartburn

On occasion, small amounts of digestive fluid do escape into the esophagus of a healthy person, for example:

  • Burping sometimes causes acid to escape with the stomach gas.
  • Overeating creates excessive pressure on the LES.
  • Lifting a heavy weight may force the LES open for a second or two while the clenched abdominal muscles squeeze acids through.
  • Bending deeply at the waist may also create more pressure on the stomach and force the LES to open briefly.
  • Strenuous exercise shortly after a meal can cause the LES to relax.
  • Going to bed or lying down shortly after eating (see the explanation below).
As a result of these factors, digestive juices attack the lining of the esophagus causing the burning sensation called heartburn. The inevitable result is that a healthy person will occasionally suffer from acid reflux.

However, there's no need to worry.

This occasional onslaught is not likely to cause injury, because the corrosive fluids are soon flushed away by:

  1. The natural secretion of saliva, which contains traces of bicarbonate (an alkaline solution that acts as an acid neutralizer).
  2. The pull of gravity tends to wash the acids downwards.
  3. Reflexive swallowing continuously clears the esophagus.
And if the heartburn persists, a level teaspoonful of aluminum-free bicarbonate of soda (such as the 'Arm and Hammer' brand) dissolved in a quarter glass of warm water will do the trick nicely.

As mentioned above, bicarbonate is a natural substance created by our own bodies in order to counteract acidity. This means that there are no harmful chemically induced side effects.

Using this method instead of resorting to over the counter antacids that often contain aluminum oxide and chemical buffering agents, is by far and away the best treatment for occasional heartburn and severe GERD - and it's also a heck of a lot cheaper than man-made chemicals ;-)

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Why GERD Increases the Frequency of Acid Reflux

There is an urgent call for action when a person suffers from Gastroesophageal Reflux Disease.

In a GERD sufferer, acid reflux followed by chronic heartburn is caused by a defective LES, which allows acid to back up into the food pipe more frequently.

For a number of reasons, the ring of muscle making up the sphincter valve is weakened. This causes the LES to remain open longer than it should and also to open spontaneously between swallows.

The LES also has a tendency to relax when a person is asleep, causing nighttime acid reflux.

This usually leads to nocturnal heartburn because:

  1. The natural secretion of saliva is reduced during sleep.
  2. The absence of the reflexive swallowing action during sleep.
  3. Gravity.
When the body is erect, the pull of gravity allows digestive fluids to wash downwards and drain back into the stomach.

This effect is reduced in the prone position. As a result, digestive juices can seep sideways through the relaxed LES and into the esophagus.

These problems are further compounded if the patient suffers from a hiatus hernia.


Other Contributing Factors
  • Taking nonsteroidal anti-inflammatory drugs (NSAID’s) such as aspirin and certain other painkillers, corticosteroids, blood pressure medication and muscle relaxants (see Acid Reflux Remedies).

  • Pregnancy. Elevated hormone levels cause the LES to relax. Also the upward pressure of the baby squashes the stomach, causing additional strain on the LES.

  • Constant use of antacids eventually causes them to become less effective. Higher doses become necessary and this leads to the overproduction of stomach acid called a "rebound effect."
  • Overeating as described above.
  • Lying down or going to bed right after dinner.
  • Obesity or carrying too much weight puts an uncalled for strain on the LES.
  • Certain foods, such as chocolate, mint and spearmint cause the LES to relax (see acid reflux Diet).
  • Incorrect body pH balance (over acidity).
  • Alcohol. Overindulgence is a major cause of a relaxed LES.
  • Smoking. Nicotine weakens the LES.
  • Having a snack or a glass of milk at bedtime.


Complications Associated With GERD

Allowing frequent attacks without seeking medical treatment can lead to serious consequences (see Barrett’s Esophagus).


When to See a Doctor

The following cannot be overstressed: If you suffer from persistent heartburn and attacks occur twice a week or more, you may have GERD...

See your healthcare provider immediately!

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