Is It an Ulcer or GERD?
These two common digestive health problems are easily confused. Find out how doctors can tell the difference.
By Madeline R. Vann, MPH
Medically Reviewed by Pat F. Bass III, MD, MPH
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That burning sensation in your stomach could be an ulcer — or it might be gastroesophageal reflux disease (GERD), a chronic acid reflux condition.
Either way, you should schedule a doctor’s visit to find out whether you have GERD or an ulcer. Both ulcers and GERD can be treated with the help of a gastroenterologist.
Ulcer or GERD: Stomach Discomfort
The two conditions are actually different, even if they make you feel equally miserable. By some estimates, one in five people experience heartburn at least weekly. Stomach discomfort can easily have a negative effect on your life, leading to:
- Lost sleep
- Difficulty enjoying social activities
- Problems with eating and drinking
Ulcer or GERD: Understanding the Differences
An ulcer is a small sore or lesion in the lining of your stomach or duodenum, the first part of your intestine. This sore is often aggravated by your stomach acid, but is usually not caused by the acid itself. More likely, the cause is either a bacterium known asHelicobacter pylori(H. pylori) or taking non-steroidal anti-inflammatory drugs (NSAIDs).
GERD, on the other hand, means that your stomach acid is coming up from your stomach into your esophagus, causing a burning sensation (sometimes referred to as acid indigestion or heartburn) and unpleasant taste in the back of your mouth. This has to occur at least twice a week to be considered GERD.
“Most patients with GERD have either heartburn or regurgitation, a sense of things coming back up into your throat,” explains James McGuigan, MD, professor of medicine in the division of gastroenterology, hepatology, and nutrition at the University of Florida College of Medicine in Gainesville. But a small percentage of people with GERD have the same kind of “epigastric” pain that patients with ulcers complain about, says Dr. McGuigan.
Ulcer or GERD: Know the Symptoms
Although you may not realize it, your description of your symptoms will help your doctor distinguish between an ulcer and GERD.
An ulcer often comes with these symptoms:
- Burning sensation in your gut, about halfway between the navel and breastbone
- Pain or discomfort two to three hours after eating
- Pain that wakes you up at night
- Pain that is eased by eating, drinking, or taking antacids
- Blood in your stool or vomit
Some symptoms of GERD that do not occur with ulcers are:
- Tasting acid or food in the back of your mouth
- Dry cough
- Sore throat
- Trouble swallowing
- Asthma-like symptoms
- Increased heartburn in response to some “trigger” foods
- Worsening of symptoms when you are lying down or bending over
Ulcer or GERD: Making the Diagnosis
Your doctor will talk to you about the pain you have been experiencing.
“Generally, when there is suspicion of an ulcer, you recommend endoscopy. If the suspicion is for GERD, you do a therapeutic trial,” says McGuigan. A therapeutic trial involves taking prescription acid-reducing medication for a while to see if that controls your symptoms.
Depending on your symptoms, your doctor may also order:
- A blood test.This will show whether you have been exposed toH. pylori.
- A barium study.With this test, also called an upper gastrointestinal or GI series, you will drink a liquid and then a radiologist takes X-rays of your esophagus, stomach, and intestine. This can show whether you have ulcers or any structural problems such as an obstruction that could be causing your symptoms.
- Endoscopy.For this test, done while you are sedated, your doctor uses a thin, flexible tube with a camera inserted down your throat to look at the inside of your esophagus and stomach. The camera allows the doctor to see ulcers or other problems, like scarring of the esophagus that could be caused by GERD.
An accurate diagnosis will get you one step closer to relief.
Video: Signs of an Ulcer
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