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Heartburn/GERD Health Center

When Heartburn Gets Serious

Ignoring heartburn -- just putting up with it, popping a few pills day after day -- isn't necessarily the best plan. There are complications that can result from letting the problem linger.
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Ignoring heartburn -- just putting up with it, popping a few pills day after day -- isn't necessarily the best plan. There are complications that can result from letting the problem linger.

"When heartburn is not appropriately treated, acid reflux can cause erosion and ulcers in the lining of the esophagus," says William C. Orr, PhD, a clinical professor of medicine and specialist in gastrointestinal disorders at the University of Oklahoma Health Sciences Center.

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Treatment Tips for Severe, Chronic Heartburn

No matter what you eat, you worry that chronic heartburn will always be there. You've tried all the antacids, followed a bland diet, given up on certain foods completely. But still you wake up in the middle of the night, sometimes with pain deep in your throat, other times with a sore throat and trouble breathing, as if you were having an asthma attack. You try to sleep sitting up in a chair, and realize with dismay: This has been going on for years.

Read the Treatment Tips for Severe, Chronic Heartburn article > >

"It's extremely painful and greatly affects the patient's lifestyle," he tells WebMD. "It really alters very significantly the quality of life."

Long-term acid reflux can cause scarring and narrowing in the esophagus, which can also lead to swallowing difficulties, Radhika Srinivasan, MD, a gastrointestinal specialist and assistant professor of medicine at the University of Pennsylvania in Philadelphia, tells WebMD.

This condition, called esophageal strictures, can interfere with eating and drinking by preventing food and liquid from reaching the stomach. Strictures are treated by dilation, in which an instrument gently stretches the strictures and expands the opening in the esophagus.

In fairly rare cases, chronic acid reflux can also cause a pre-cancerous condition called "Barrett's esophagus," she adds. Barrett's esophagus is a result of the chronic acid reflux into the esophagus (swallowing tube) causing dangerous changes in the cells that line the esophagus -- these cells can become cancerous.

The odds: If 100 people have heartburn on a regular basis for many years, ten would have Barrett's esophagus; one out of those ten would develop esophageal cancer.

Whether you are at risk depends on long you have had symptoms and their frequency, Srinivasansays.

Thus, Barrett's esophagus is not a condition to be taken lightly. The goal of treatment is to prevent further damage by stopping any acid reflux from the stomach. For acid reflux, doctors may start with medications such as Pepcid, Zantac, or Tagamet which are known as H2 blockers. These medications, which are available over the counter and by prescription, inhibit the release of acid in the stomach. Lifestyle changes also help with symptoms.

For persistent or worsening symptoms or cases of Barrett's esophagus, doctors usually give patients proton pump inhibitor medications that block acid production like Aciphex, Nexium, Protonix, Prevacid, and Prilosec. If these medications do not limit the effects of reflux, surgery to tighten the sphincter, or valve between the esophagus and stomach, may be necessary. Doctors can also use a technique called ablation to destroy the abnormal tissue.

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