What’s the Difference Between GERD and Acid Reflux?

What’s the Difference Between Acid Reflux and GERD?

What’s the Difference Between Acid Reflux and GERD?
iStock; Everyday Health

Got a burning feeling in your upper chest after a meal? If you’re thinking it’s acid reflux (sometimes referred to by the name of its main symptom, heartburn), you’re probably right.

“Heartburn is the manifestation — the symptom — of acid reflux, which is when stomach contents come back up your esophagus,” says Matilda Hagan, MD, a gastroenterologist and the associate director of the Center for Inflammatory Bowel and Colorectal Diseases at Mercy Medical Center in Baltimore.

You can often pinpoint a reason for the burn (that five-alarm chili, perhaps?), but if you’re having heartburn at least twice a week for more than a few weeks, it could be a symptom of a more serious condition called gastroesophageal reflux disease (GERD).

While it may seem that GERD is just a fancy name for acid reflux, they are more like close cousins than identical twins. Below, find out how they differ and what that means for treatment.

What Is Acid Reflux?

After you swallow food, it makes its way down the esophagus and into the stomach, where a ring of muscle, called the lower esophageal sphincter (LES), closes to keep the food in. But sometimes the LES is weak or doesn’t properly close, allowing stomach contents to back up, which irritates the lining of the esophagus. That’s acid reflux, which may be asymptomatic or come with symptoms like heartburn, nausea, and sore throat, among others.

More than 60 million Americans experience acid reflux at least once a month. Symptoms include:

  • Heartburn, which is a burning sensation in the center of your chest, especially after meals or at night
  • Chest pain that is worse if you bend over or lie down
  • A sour, bitter, or acidic taste in the back of your throat
  • A feeling that food is stuck in your throat or the middle of your chest
You can generally avoid occasional bouts of acid reflux with some lifestyle modifications. Your doctor will likely suggest that you try to treat acid reflux by making the following lifestyle changes before trying medication:

  • Avoid foods that trigger reflux for you. Spicy, acidic, and fried and fatty foods are more likely to trigger reflux. Caffeine and alcohol are, too.
  • Stay upright after eating a big meal to allow for optimal digestion. “It’s best to not eat in the hours leading up to bedtime,” says Dr. Hagan.
  • If you have excess weight or have obesity, losing weight can help. (Obesity is a factor in the weakening of the lower esophageal sphincter.)

  • If you smoke, vape, or use other forms of nicotine, do your best to quit. Nicotine relaxes the lower esophageal sphincter.

When Acid Reflux Is Chronic: What Is GERD?

GERD is acid reflux that occurs regularly. It is estimated that up to 20 percent of the U.S. population has GERD.

It’s not the case that a person who has occasional reflux will necessarily progress toward having GERD, says Louis Cohen, MD, a gastroenterologist and assistant professor of medicine at Mount Sinai in New York City. But the symptoms of GERD are the same as those of acid reflux, such as the burning feeling in your chest and the sensation that your stomach contents are in your throat. You may also have a dry cough or trouble swallowing, among other symptoms.

A primary care doctor or gastroenterologist can usually diagnose the condition by evaluating symptom frequency and severity.

“We may also put a probe into a patient’s esophagus for a day to measure how frequently reflux happens,” says Dr. Cohen. Knowing how often reflux occurs is another way to confirm a diagnosis, beyond evaluating the symptoms.

Treatment for GERD starts with lifestyle modifications, says Hagan: “We’ll ask patients to try these steps before we offer medication, although we understand that it can be hard to do some things, such as quitting smoking.”

One class of medication used to treat GERD is proton pump inhibitors (PPIs), which are available over the counter and by prescription. This class includes:

  • lansoprazole (Prevacid)
  • esomeprazole (Nexium)
  • omeprazole (Prilosec)
  • omeprazole/sodium bicarbonate (Zegerid)
  • dexlansoprazole (Dexilant)
  • pantoprazole (Protonix)
  • rabeprazole (AcipHex)
PPIs work by decreasing the amount of acid that your stomach produces, which allows the esophageal lining to heal. PPIs are typically safe and effective, although they may lead to side effects such as headaches, upset stomach, and diarrhea, among others.

Some evidence suggests that PPIs are linked to an increased risk of infection from Clostridioides difficile, or C. diff. They’ve also been tied to other potential risks, especially with long-term use, including bone fractures (due to their impact on calcium absorption), kidney disease development or advancement, and magnesium and vitamin B12 deficiencies, though evidence is inconclusive. Make sure to discuss the risks and benefits with your doctor.

Other drugs called H2 blockers, which inhibit histamine 2 receptors in the stomach, such as famotidine (Pepcid), cimetidine (Tagamet), and nizatidine, may also be effective, says Hagan. H2 blockers lower stomach acid production, though they’re not considered to be as strong as PPIs and are available over the counter and by prescription.

But sometimes people have GERD symptoms that aren’t caused by reflux. “If we determine that GERD symptoms are caused by hypersensitivity in the esophagus or excessive relaxation of the lower esophagus, we might prescribe tricyclic antidepressants or selective serotonin reuptake inhibitors,” says Cohen.

For people who do not respond well to medication or cannot tolerate it, surgery may be an option. A number of surgical procedures to treat GERD are available to strengthen the barrier between the stomach and the esophagus. If this is an option, your gastroenterologist will help you decide which procedure is best for you.

Delaying Treatment for GERD May Lead to Complications

If GERD goes untreated, it can lead to more serious complications. One such issue is esophagitis, which is inflammation in the lining of the esophagus. Hagan says that if esophagitis is not treated, you may develop a stricture, which is a narrowing of the esophagus that can lead to esophageal pain and affect proper swallowing.

Another complication of GERD is a condition called Barrett’s esophagus (BE). “Over time, the stomach acid causes cells in the lining of the esophagus to look more like the stomach lining,” says Hagan. These changes, which happen on a cellular level, may in rare cases lead to a form of esophageal cancer. BE is more common in these people:

  • Those with a family history of the condition
  • Males
  • White people
  • People older than age 50
  • Smokers and former smokers
  • People who are overweight
Esophageal cancer is relatively rare, making up just 1 percent of all cancer diagnoses in the United States. However, as rates of GERD and obesity have increased, the incidence of esophageal adenocarcinoma (a form of esophageal cancer) has been on the rise in the United States.

Furthermore, a study found that this form of cancer is on the rise in adults younger than 50: Between 1975 and 2015, the incidence of esophageal adenocarcinoma increased by an average of 2.9 percent per year.

If you have BE, your doctor may recommend surveillance endoscopies, Hogan says. That means they’ll perform an endoscopy periodically to see how well your esophagus is healing in response to drug therapy, which you’ll continue taking long term.

If you’re experiencing acid reflux at an increased frequency, talk to your doctor about testing to uncover the underlying issue. If you learn to treat GERD with lifestyle changes or medication, you can avoid more serious complications.

Additional reporting by Ashley Welch.

Resources We Trust

EDITORIAL SOURCES
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Resources
  1. Acid Reflux & GERD. Cleveland Clinic. July 8, 2026.
  2. How to Tell the Difference Between Heartburn and Heart Attack. UC Davis Health. July 24, 2024.
  3. Managing Acid Reflux. Alberta Health Services. July 2024.
  4. Gavini S. Acid Reflux / GERD (Gastroesophageal Reflux Disease). American College of Gastroenterology. April 2025.
  5. Gastroesophageal Reflux Disease (GERD). Johns Hopkins Medicine.
  6. Proton Pump Inhibitors. Cleveland Clinic. September 28, 2023.
  7. H2 Blockers. Cleveland Clinic. March 18, 2024.
  8. Reflux Surgery. Memorial Hermann.
  9. Barrett’s Esophagus. Mayo Clinic. February 8, 2023.
  10. Key Statistics for Esophageal Cancer. American Cancer Society. January 13, 2026.
  11. Facts about Esophageal Cancer. Fred Hutch Cancer Center. April 3, 2026.
  12. Codipilly DC et al. Epidemiology and Outcomes of Young-Onset Esophageal Adenocarcinoma: An Analysis from a Population-Based Database. Cancer Epidemiology, Biomarkers & Prevention. January 11, 2021.
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Ira Daniel Breite, MD

Medical Reviewer

Ira Daniel Breite, MD, is a board-certified internist and gastroenterologist. He is an associate professor at the Icahn School of Medicine at Mount Sinai, where he also sees patien...

Denise Schipani

Denise Schipani

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Denise Schipani is a New York–based editor and writer with a special interest in health and healthcare. Her work has appeared in a wide range of consumer and custom magazines and w...