Acid Reflux and Heartburn: Are They the Same?

Gastric acid reflux and heartburn are very similar and related terms, but they don't mean the same thing. The former is the cause, while the latter is the consequence.

Written and verified by the biologist Samuel Antonio Sánchez Amador.

Last update: 10 March, 2023

Gastrointestinal diseases are the order of the day, as statistical portals estimate that 22% of Americans and 21% of Europeans over the age of 18 have some type of digestive condition. Two very common terms related to this subject are acid reflux and heartburn.

Although these concepts are familiar to all of us, it isn’t so easy to answer the following questions. Are both conditions the same? What are the differences between reflux and heartburn? Don’t worry, because here we’ll answer these questions and many more.

What is heartburn?

Firstly, we need to clarify that heartburn is a symptom, while gastroesophageal or acid reflux can be the cause of it. Thus, heartburn is defined as a painful burning sensation in the chest or throat. According to the U.S. National Library of Medicine, pregnancy, some foods, medications, or alcoholic beverages can cause it.

Heartburn is a more common discomfort than many people might think. Here are some statistics gathered from various sites:

• 10% of adult humans have heartburn on a daily basis and 30% once a month.
• In the United States, the incidence – the number of new cases in the population – was 26% in 2015.
• Overall, an estimated 20% of the population at any given place and time suffers from heartburn.

What is acid reflux?

On the other hand, acid reflux is considered a clinical condition. According to pediatric portals, this pathology is characterized by a movement of the stomach contents in the opposite direction, that is, towards the esophagus.

Humans have an opening between the stomach and the esophagus that acts as a door, which closes as soon as the food bolus passes into the stomach. If this doesn’t work properly, food and stomach acid can back up into the esophagus, causing irritation in the esophagus and the heartburn described above.

What is GERD?

Gastroesophageal reflux disease (GERD) is a more serious case of acid reflux, i.e. a chronic disease. A symptom of this disease is heartburn more than twice a week, although it’s possible to have GERD without signs of heartburn.

Again, the mechanism is the same as described in the previous case – the ring of muscle fibers – lower esophageal sphincter (LES) – doesn’t close properly, so the stomach contents can go back up into the esophagus.

According to experts, some of the symptoms are as follows:

• Pain in the stomach
• Non-burning chest discomfort that can sometimes be mistaken for a heart attack
• Pain when swallowing
• Chronic pharyngitis, cough and sinusitis
• Pneumonia and waking up with choking sensation

Thus, we can conclude that heartburn is a symptom, gastric acid reflux is its possible cause and GERD occurs when the patient suffers episodes of heartburn more than twice a week.

Over-the-counter treatment for acid reflux

First of all, health institutions such as the Mayo Clinic warn us of the following: if you have heartburn more than twice a week, if you have trouble swallowing, if you have nausea and vomiting, or if you have lost weight because of this symptom, it’s time to see a doctor.

In all other cases, reflux and heartburn can be regulated with over-the-counter medications. Some of those available are as follows:

• Antacids, as the name implies, reduce the effects of acid in the stomach by neutralizing it. They provide rapid, short-term relief, and also come in an easy-to-take form – capsules and tablets.
• H2 blockers, such as famotidine, don’t relieve symptoms as quickly, but are more effective. They reduce the amount of acid produced in the stomach.
• Proton pump inhibitors (PPIs) also reduce acid production. These are the best options to pursue when H2 blockers don’t work or in people with GERD. Even so, their effect is much less immediate, as they take a few days to start working. Omeprazole is one such drug in this family.

Precautions to consider

Certain risk factors favor the appearance of gastric acid reflux and heartburn. For example, alcohol consumption or acidic substances such as coffee can cause the condition.

In addition, obesity, pregnancy, and smoking are also factors that can promote this unpleasant reflux. As a last tip, people prone to suffer from it are recommended not to lie down less than three hours after eating, as this facilitates the ascent of acids to the esophagus.

Controlling gastric acid reflux

As we have seen, these types of intestinal conditions are common, as up to 30% of the population suffers from heartburn at least once a month. Although it may be easy to combat heartburn at home, the most serious cases require immediate medical attention.

To answer the question we posed at the beginning, we can conclude that heartburn is a symptom of gastric acid reflux. If it becomes chronic, the patient may develop gastroesophageal reflux disease (GERD).