Which statement best defines the clinical distinction between occasional heartburn and gastroesophageal reflux disease (GERD)?

• A. Heartburn refers to pain exclusively caused by cardiac ischemia with no relation to the esophagus; GERD is the result of an underactive pyloric sphincter allowing bile to damage the stomach lining, leading to chronic nausea and immediate vomiting after meals.
• B. Heartburn and GERD are identical terms used interchangeably; both refer to erosion of the stomach lining by infection with Helicobacter pylori that causes chest pain and requires antibiotic therapy, and the terms have no temporal distinction.
• C. Heartburn is any discomfort within the abdomen from overeating, while GERD is defined as a psychosomatic condition that mimics heart disease and is best treated by psychotherapy and avoidance of fatty foods.
• D. Heartburn is occasional retrosternal burning due to transient reflux; GERD is chronic frequent reflux that causes persistent esophageal mucosal injury and potential complications.

Answer: (D)