Acid Reflux, GERD or Angina: What’s the Difference?

11/7/2017

Tennova Healthcare offers tips for better digestive health

It’s your birthday, and you just finished celebrating with a big meal and cup of coffee. What comes next is something that was definitely not on the menu—the worst case of heartburn you’ve ever experienced. But wait… could that pain be something more serious?

November 20–26 is GERD Awareness Week, and Tennova Healthcare is taking the opportunity to educate the community on the overlapping symptoms of acid reflux, GERD and angina, and steps you should take to address chest discomfort.

“One of the more difficult tasks confronting healthcare providers is distinguishing among the various possible causes of chest pain,” said Michael R. Ellis, M.D., a gastroenterologist with Tennova Healthcare. “Nearly 20 percent of patients who see their primary care physician for chest discomfort have gastrointestinal problems. But, there are even distinctions between the possible GI-related causes. Heartburn, GERD and acid reflux are similar, but not necessarily the same conditions.”

Acid reflux refers to the backward flow of stomach acid into the esophagus (the tube that connects the throat and stomach). During an episode of acid reflux, you may taste regurgitated food or sour liquid at the back of your mouth, or feel a burning sensation in your chest.

GERD, or gastroesophageal reflux disease, is a more severe and chronic form of acid reflux. The most common symptom of GERD is frequent heartburn. Other signs and symptoms may include regurgitation of sour food or liquid, difficulty swallowing, coughing, wheezing, and chest pain, especially when lying down at night.

Occasional heartburn or reflux can be treated with over-the-counter antacids or medications, such as H2-receptor blockers (like Pepcid AC) or proton pump inhibitors (like Prilosec). But, if the condition becomes chronic, or you suspect you may have GERD, talk to your doctor about some of the minimally invasive procedures that can provide relief.

Angina can be a signal of a more dangerous heart condition. Angina is chest pain or discomfort that occurs if an area of your heart muscle doesn't get enough oxygen-rich blood. It may feel like pressure or squeezing in your chest. It may even feel like indigestion. Angina pain also can occur in your shoulders, arms, neck, jaw or back.

“Sometimes it’s difficult even for physicians to tell the difference between the symptoms of angina, heartburn or heart attack,” Dr. Ellis said. "There’s no one symptom that can reliably distinguish one condition from the other, so if in doubt, have it checked out.”

While there is overlap in the various symptoms, there are some indicators both common and unique to GERD and angina. If your chest pain is centered beneath your breastbone, gets worse with exertion, improves with rest or radiates to both arms, it is more likely to be angina. Chest pain that gets worse when lying down or bending over is more likely to be caused by GERD. There are also certain diagnostics and physical findings that may point to one condition or the other.

“If the patient’s blood pressure is abnormally low, has profuse sweating, has excess fluid in the lungs or abnormal heart sounds, we are more likely to suspect angina,” Dr. Ellis said. "If the pain is aggravated by applying pressure to the pit of the stomach, or it’s relieved by antacids, the diagnosis is more likely GERD.”

If you find yourself suffering from GERD, or just occasional heartburn, here are some simple diet and lifestyle changes you can make, which will often address the problem without medication or treatment:

• Defy gravity. Don’t lie down within three hours of eating. That is when acid production is at its peak. Plan early suppers, and avoid bedtime snacking.
• Eat small meals (especially late in the day). Make your main meal of the day the midday meal.
• Experiment with trigger foods. Foods that cause reflux differ from person to person. Start by removing fatty foods, onions and chocolate. Coffee, colas, tomatoes and citrus juices may also irritate the esophagus or stimulate excess stomach acid production. Try removing one or two foods at a time until you find what works best for you. Peppermint may relax the circular muscle between the esophagus and the stomach (the lower esophageal sphincter), and allow stomach acid to migrate into the esophagus.
• Watch your weight. Losing even a modest amount of weight can reduce the intensity or frequency of symptoms. Excess weight gain and abdominal pressure during pregnancy are a common cause of reflux. Once the weight is lost after childbirth, the condition typically goes away.
• Reduce your stress levels. Stress makes reflux worse. Practicing yoga or meditation is an excellent non-medical treatment for occasional or modest reflux.

“You don’t have to live with heartburn or gastric discomfort,” Dr. Ellis said. “These conditions are more common than you may think, and a physician can help you discover both the cause and the solution.”

The bottom line is, unless you have significant risk factors for—or an existing diagnosis of—heart disease, the most likely culprit for your pain after that big celebration meal is heartburn. But if the pain is unfamiliar, and the cause is uncertain, call 9-1-1 immediately.

For more information or to find a doctor who specializes in gastrointestinal health, call 1-855-TENNOVA (836-6682).

About Tennova Healthcare
One of the state’s largest health networks, Tennova Healthcare includes 16 hospitals and more than 115 physician clinics. The combined network has approximately 2,600 licensed beds, 2,800 physicians on the combined active medical staffs, and 9,000 employees, with more than 70,000 admissions and 465,000 emergency department visits each year.

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