Gastroesophageal reflux disease (GERD) and gastritis are two common stomach conditions that share some similar symptoms, but also have key differences. Understanding whether your symptoms point more towards GERD or gastritis can help guide proper treatment.
What is GERD?
GERD stands for gastroesophageal reflux disease. It occurs when stomach acid frequently flows back up into the esophagus. The esophagus is the tube that connects the mouth to the stomach. This backwash of acid irritates the lining of the esophagus and causes common symptoms like:
- Heartburn
- Regurgitation of food or sour liquid
- Sensation of a lump in the throat
- Chest pain
These symptoms tend to be worse after eating, when lying down, or bending over. The reflux happens because the muscle that connects the esophagus and stomach (lower esophageal sphincter) relaxes at the wrong times. Risk factors for GERD include obesity, pregnancy, hiatal hernia, and certain medications.
What is gastritis?
Gastritis refers to inflammation in the lining of the stomach. There are several potential causes including:
- Infection with H. pylori bacteria
- Long-term use of NSAIDs like ibuprofen
- Excessive alcohol use
- Stress
- Autoimmune disorders
Gastritis can occur suddenly (acute gastritis) or persist over time (chronic gastritis). Common symptoms include:
- Upper abdominal pain or burning
- Nausea
- Loss of appetite
- Bloating
- Vomiting
Symptoms may be worse after eating or feel better with antacids. More severe cases can result in bleeding in the stomach.
Key differences between GERD and gastritis
While GERD and gastritis share some general stomach-related symptoms, there are key differences that can help distinguish which condition you may have:
| GERD | Gastritis |
|---|---|
| Main symptom is heartburn | Main symptom is upper abdominal pain |
| Chest pain common | Chest pain less common |
| Regurgitation of food/liquid common | Regurgitation less common |
| Usually not associated with nausea/vomiting | Nausea/vomiting more common |
| Brought on by lying down, bending over | Not positional |
| Relieved by antacids | May be relieved by antacids |
| Can lead to esophagitis | Does not affect esophagus |
What causes each condition?
GERD and gastritis also have different underlying causes:
GERD causes
- Hiatal hernia – when part of the stomach protrudes through the diaphragm and allows acid backflow
- Pregnancy – hormones cause relaxation of the esophageal sphincter
- Obesity – increased pressure against the stomach
- Medications – sedative hypnotics, calcium channel blockers, nitrates
- Smoking, alcohol, chocolate, spicy foods – these can lower esophageal sphincter pressure
Gastritis causes
- H. pylori infection – this bacteria can damage the stomach lining
- Long-term NSAID use – these pain relievers can irritate the stomach lining
- Excessive alcohol use – this irritates and inflames the stomach lining
- Stress – psychological stress increases stomach acid production
- Autoimmune disorders – these can cause the immune system to attack the stomach
How are GERD and gastritis diagnosed?
GERD and gastritis often have overlapping symptoms, so specific tests may be needed to reach the correct diagnosis. These may include:
GERD diagnosis
- Endoscopy – A small camera on a flexible tube is used to look at the esophagus. This can detect damage from acid reflux.
- Biopsy – Taking a small sample of tissue from the esophagus to check for cell changes under a microscope.
- pH monitoring – A probe measures acid levels in the esophagus over 24 hours.
- Manometry – A pressure monitor checks if the lower esophageal sphincter is working properly.
Gastritis diagnosis
- Endoscopy – Looks for inflammation or damage to the stomach lining.
- Biopsy – Takes samples of stomach tissue to test for H. pylori infection or other abnormalities.
- Blood tests – Can check for H. pylori antibodies.
- Stool test – Checks for presence of H. pylori bacteria.
How are GERD and gastritis treated?
Treatment focuses on reducing acid levels in GERD and controlling inflammation in gastritis:
GERD treatment
- Antacids like Tums or Rolaids
- H2 blockers like Pepcid, Zantac
- Proton pump inhibitors like Prilosec, Nexium
- Surgery like fundoplication for severe cases
- Lifestyle changes – lose weight, avoid trigger foods/drinks, don’t eat late
Gastritis treatment
- Antibiotics for H. pylori infection
- Discontinue NSAID pain relievers
- Reduce alcohol intake
- Proton pump inhibitors to reduce stomach acid
- Histamine-2 blockers
- Antacids
- Avoid trigger foods
Conclusion
GERD and gastritis both cause stomach discomfort and pain, but have distinct differences. GERD stems from acid reflux irritating the esophagus, while gastritis is an inflammation of the stomach lining itself. Knowing whether you have more symptoms of heartburn, regurgitation, and chest pain (GERD) or nausea, appetite loss, and upper abdominal pain (gastritis) can help get you the right diagnosis and treatment. Diagnostic tests like endoscopy can also determine if there is damage to the esophagus lining typical of GERD versus solely inflammation in the stomach from gastritis. Treatment aims to reduce stomach acid for GERD, while controlling the underlying triggers of inflammation for gastritis. Being aware of these key distinctions can get you on the path to feeling better.