Stomach Ulcer vs Acid Reflux (GERD): How to Tell Them Apart
Burning discomfort in the upper body is extremely common worldwide. Two of the most frequent causes are peptic ulcers and gastro-oesophageal reflux disease (GERD). They can feel similar but are different conditions.
Acid reflux and GERD
Reflux happens when stomach contents flow back into the oesophagus. GERD is when this happens often enough to cause symptoms or damage.
Typical signs:
- Heartburn: burning behind the breastbone, often after meals or when lying down
- Sour or bitter taste in the mouth
- Regurgitation of food or liquid
- Hoarseness or cough, sometimes
Peptic ulcer
An ulcer is a sore in the stomach or duodenum.
Typical signs:
- Burning or gnawing pain in the upper abdomen, below the breastbone
- Pain on an empty stomach or a few hours after meals
- Night-time pain
- Bloating, nausea, feeling full quickly
Key differences
- Location: reflux tends to burn in the chest; ulcer pain is usually in the upper abdomen.
- Position: reflux often worsens when lying down or bending over.
- Cause: reflux is linked to the valve at the bottom of the oesophagus, weight, large meals and some foods; ulcers are mostly caused by H. pylori or painkillers.
You can have both
Many people have both conditions, and some symptoms overlap. Acid-reducing medicines can help both, which is one reason the underlying cause may be missed.
When to get checked
- Symptoms lasting more than a few weeks
- Pain that wakes you at night
- Difficulty swallowing, weight loss, vomiting, black stools or anaemia
- New symptoms later in life
Ask your doctor about H. pylori testing: treating it can resolve ulcer disease, while reflux usually needs a different long-term approach.
Key takeaway
Chest burning that worsens lying down points to reflux; gnawing upper-abdominal pain points to an ulcer. Because they overlap, proper testing is the only way to know, and to treat the right problem.
