GER vs. GERD: Everything to Know About Heartburn

Gastroesophageal reflux (GER), also sometimes referred to as acid reflux, is a digestive phenomenon that occurs when stomach contents come back up into your esophagus. This can cause symptoms such as pain or burning in the chest (heartburn), sore throat, gas, bloating, and bad breath.

When GER occurs in repeated bouts, it is considered to be a digestive disorder called gastroesophageal reflux disease (GERD). This happens when the lower esophageal sphincter (LES) either becomes weak or it relaxes when it shouldn't. Obesity, smoking, diet, and pregnancy are also risk factors for this condition. 

This article will discuss the differences between GER and GERD as well as treatment options and the medical complications that may come about if left untreated. 

GER vs. GERD: What Are the Differences?

Gastroesophageal reflux occurs when the amount of gastric juice that refluxes into the esophagus exceeds the normal limit, causing damage to the lining of the esophagus. Gastroesophageal reflux disease is a more severe and long-lasting condition characterized by repeated GER symptoms, such as:

• Coughing
• Bad breath
• Heartburn
• Trouble swallowing (dysphagia)
• Sore throat
• Vomiting
• The feeling of food caught in your throat
• Non-burning chest pain
  

Over time, GERD can cause medical complications, such as:

• Adult-onset asthma
• Inflammation, irritation, or swelling of the esophagus (esophagitis)
• Narrowing of the esophagus (esophageal stricture)
• Barrett's Esophagus (pre-cancerous changes to the esophagus)
• Sinusitis
• Peptic ulcers

How GER and GERD Are Treated

Medical intervention is typically not needed if you have occasional bouts of GER. In adults, lifestyle changes, such as avoiding the food that triggered your GER or not lying down after you eat, may resolve your symptoms. You can also try over-the-counter medication to manage symptoms.

Treatment for GERD

If you have repeated bouts of GER, it may signal that you have a larger issue, GERD, which may call for more profound lifestyle changes and the use of medications such as antacids and proton pump inhibitors (PPIs). 

Treating GERD can be lifesaving. If left untreated, reflux of stomach acid into the esophagus through the lower esophageal sphincter slowly damages the esophageal lining, leading to gastric symptoms and a number of serious medical conditions, including throat cancer.

The frequency and severity of your symptoms will typically determine whether you need to make lifestyle changes, take medicines, or both to manage symptoms of GERD.

Knowing the risk factors that contribute to GERD and the triggers that cause exacerbations—like spicy foods, high caffeine intake, obesity, and smoking—can help you avoid GERD and reduce your need for medication. Lifestyle changes may differ for infants and adults. 

Lifestyle Changes for Infants

If your baby has GER or GERD, the following lifestyle changes can help reduce or prevent symptoms:

• Avoid exposing the infant to secondhand smoke
• Burp your infant more often
• Change the infant’s diet
• Hold the infant upright for 20 or 30 minutes after they eat
• Make sure your baby is always sleeping on their back 

Lifestyle Changes for Adults

If you have recurrent GERD, the following lifestyle changes may help reduce your symptoms and increase your quality of life:

• Losing weight if you’re overweight or have obesity
• Elevating your head during sleep by placing a foam wedge or extra pillows under your head and upper back to incline your body and raise your head off your bed six to eight inches
• Taking a walk after a meal to aid in digestion
• Quitting smoking 
• Changing your eating habits and diet
  

Prevention: How to Stave Off GERD

GERD is highly preventable without the need for medication if you are willing to make a few lifestyle modifications. The advantages of addressing your GERD are far greater than reducing your nagging symptoms of bad breath and heartburn.

The following steps can prevent GERD:

• Weight loss: Extra abdominal fat places pressure on your abdomen, pushing gastric juices up into your esophagus.
• Avoid trigger foods: Spicy foods, onions, chocolate, caffeine, and junk food have all been shown to increase the prevalence of GERD.
• Don’t lie down after eating: Gravity is a major contributor to food digestion. When you lie down gravity is negated making it more likely for acid to backflow from the stomach through the esophageal sphincter and into the esophagus. 
• Eat food slowly and chew thoroughly: More food in the stomach can mean more acid buildup. Eating smaller meals and small portions can decrease acid reflux.
• Avoid tight-fitting clothing.
• Quit smoking: Nicotine relaxes the esophageal sphincter allowing for acid to enter.
• Limit alcohol: Like smoking, alcohol can relax the LES.
• Elevate your bed: Elevating the entire top half of your body, not just your head, six to eight inches means that gravity is reintroduced, resolving the backflow of stomach acid into the esophagus. 
• Avoid carbonated beverages: They make you burp and may bring acid up along with the gas. 
  

Summary

GER occurs when acid, food, or fluids in the stomach back up from the stomach into the esophagus causing symptoms of coughing, bad breath, heartburn, and trouble swallowing. When GER occurs repeatedly, it is called GERD. Untreated GERD is associated with a number of medical conditions that can greatly impact your quality of life.

A Word From Verywell

GER and GERD are highly preventable and you don’t need medication to do it, but the plan that works for one person may not work for another. If your GERD symptoms are worsening, contact a healthcare provider. Not only can they give you a formal diagnosis, but they can suggest lifestyle modifications and medications that are best suited for you.