Distinguishing GERD From Peptic Ulcer Disease

Harley R. Liker, MD, MBA


September 02, 2003


Which clinical features help to most reliably distinguish GERD from symptoms due to peptic ulcer disease?

Response from Harley R. Liker, MD, MBA

The classic symptoms of GERD are heartburn and/or regurgitation. If a patient complains of a burning sensation rising from the stomach into the chest or towards the neck, it is most likely due to GERD. Peptic ulcer disease, however, is typically manifested by symptoms including pain or discomfort localized in the center part of the abdomen. Classically, GERD symptoms such as heartburn or regurgitation may often be exacerbated by alcohol and certain foods, including those containing caffeine, garlic, and peppermint, as well as fatty foods. These foods and alcohol often cause relaxation of the lower esophageal sphincter, allowing the refluxate to enter into the esophagus from the stomach, thus causing heartburn or regurgitation. However, peptic ulcer disease is often improved when a patient either has an empty stomach or consumes food to satiety, because eating to fill the stomach may often relieve peptic ulcer symptoms.