People often confuse heartburn and gastroesophageal reflux disease (GERD). There's a good reason for this. Heartburn, a burning pain behind the breastbone that can move up to the neck and throat, is the most common symptom of GERD.

GERD is a condition that affects the esophagus, the tube that connects the throat and stomach. The muscular valve at the bottom of the esophagus is called the lower esophageal sphincter (LES). Normally, the LES opens to allow food into the stomach and closes afterward. When the LES relaxes at the wrong time, it can allow food and acids from the stomach to reflux, or flow back, up into the esophagus.

Heartburn is not the only symptom of GERD. In fact, older adults may not have heartburn at all. Other symptoms can include:

nausea
gagging
trouble swallowing
chronic coughing
hoarseness
vomiting
chest pain.

Taking an over-the-counter antacid for occasional heartburn is fine. If you use antacids for longer than three weeks at a time, talk to your doctor. You could have GERD.

If left untreated, GERD can damage the lining of the esophagus -including scarring, inflammation, ulcers, and bleeding. The esophagus can narrow as a result of long-term scarring. GERD also may lead to Barrett's esophagus, a disorder of the cells lining the esophagus. About 5 to 10% of people with Barrett's esophagus develop esophageal cancer.

If you are diagnosed with GERD, your doctor may prescribe medication. Some of these block acid production; others speed up the emptying of the stomach. In rare cases, surgery is needed to strengthen the LES.

There are also a number of lifestyle steps that can help relieve GERD. If you are prone to heartburn, they also may keep you from developing GERD in the first place.
Avoid chocolate, peppermint, coffee, and alcohol- these are known to weaken the LES.
Keep away from citrus fruits and juices, tomato products, and pepper.
Decrease portions at mealtime so the stomach will require less acid to do its job.
Avoid lying down for two to three hours after eating, allowing time for acid in the stomach to decrease.
If you smoke, stop. Smoking weakens the LES.
If you are carrying extra pounds, lose some weight; this may help reduce pressure on the LES
Elevate the head of your bed on 6 inch blocks, or sleep on a specially designed wedge. This can allow gravity to lessen reflux.
Sleep on your left side, if possible; this position may reduce reflux.