Even the most enjoyable meal can produce unpleasant or even painful sequelae with acid reflux. You may have heartburn, a burning sensation in your chest, or feel the need to burp or clear your throat repeatedly. Heartburn is common for many people, but it could be a sign of a more serious condition known as GERD.

Heartburn is a burning pain behind the breastbone. It’s the most common gastrointestinal symptom, with more than 60 million Americans experiencing flare-ups at least once a month. Heartburn is triggered by certain foods and drinks, or by eating too much. It often goes away on its own after a few minutes, although it can last for hours and require over-the-counter medication.

The occasional heartburn is nothing serious, but its symptoms can mimic gastroesophageal reflux disease, or GERD.

“These common digestive issues are often confused with each other because they share many of the same traits,” says Dr. Lawrence Friedman, deputy chief of medicine at Massachusetts General Hospital and medical editor of Harvard Health’s Cooling Heartburn online guide. Publishing. “Although they are connected, they are quite different.”

Severe and recurring heartburn is a symptom of frequent or persistent acid reflux, also known as GERD. For people with GERD, stomach acid rises from the stomach into the esophagus, much like water bubbling up a sink from a clogged drain. When stomach acid reaches the esophagus, it can trigger heartburn.

Heartburn from GERD often extends from the bottom of the rib cage to the base of the neck and can last for hours. It may be accompanied by a tingling sensation in the throat and a bitter taste in the mouth. “You should get checked for GERD if you have heartburn more than twice a week,” says Friedman.

Left alone, GERD can lead to complications like esophagitis (inflammation of the esophagus) and sometimes precancerous changes in the lining of the esophagus (called Barrett’s esophagus).

Although severe heartburn is the most common symptom of GERD, there are others, including:

• Nausea
• Difficulty swallowing
• Sore throat
• Regurgitation, which may present as a “wet burp” or as vomit
• Coughing, wheezing, or constant need to clear your throat
• Hoarseness, especially after waking up

The most common cause of GERD is dysfunction of the lower esophageal sphincter (LES), the muscular ring that separates the esophagus from the stomach. Usually it functions as a door. The muscle relaxes when you swallow, which opens the passage between the esophagus and the stomach and allows the passage of food.

When the sphincter tightens, it closes the pathway, preventing food and acidic stomach juices from backing up into the esophagus. However, with GERD, the LES relaxes when it shouldn’t, or it weakens and stays partially open. This allows stomach acid to rise into the esophagus.

For heartburn and GERD, diet changes and medication can help you avoid discomfort.

Reduce trigger foods and drinks associated with heartburn, such as mint, fatty and spicy foods, tomatoes, onions, garlic, chocolate, coffee, tea, soft drinks and alcohol . Also try to eat smaller meals, sit still for at least an hour after eating, and avoid eating two hours before bedtime.

Over-the-counter antacids or acid-blocking medications neutralize digestive acids in the stomach and esophagus; these work well for mild, occasional heartburn. Your doctor may recommend acid reducers like H2 blockers or proton pump inhibitors (PPIs) for persistent or severe symptoms. These drugs are found in many over-the-counter products, with stronger versions available by prescription.

Many self-help remedies for heartburn also help manage GERD. If these do not provide relief, you may need to consider surgery to tighten your LES.

GERD is also associated with a hiatal hernia, where your stomach punches a hole in your diaphragm and weakens the ligaments that hold your esophagus in place, making it more difficult for LES to function properly.

Almost everyone with a large hiatus hernia has GERD, and hiatus hernias are commonly found in people with GERD who also have moderate or severe esophagitis.

Hiatal hernia usually does not require treatment. “However, you may need surgery to repair the hernia if you have persistent reflux symptoms, if you have esophagitis that does not heal with medication, or if the hiatal hernia is so large that a part of the stomach sits above the diaphragm,” says Friedman. .