For most people, the painful burning sensation in the chest that comes from heartburn is just an occasional mild annoyance. But for those who experience it on a regular basis, uncontrolled heartburn can turn into a very serious problem.
Heartburn is the most common symptom of gastroesophageal reflux disease, or GERD. GERD results from the improper working of the ring of muscle that normally keeps food and acids inside the stomach. When it doesn't work correctly, it allows acids to back up into the esophagus.
A physical exam for hiatal hernia is similar to that for heartburn, with two additions: X-rays may be ordered to show the hernia, and if anemia is a concern, a blood sample may be taken to check your red blood cell count.
A hiatal hernia can be diagnosed with a specialized X-ray study that allows visualization of the esophagus and stomach (barium swallow) or with endoscopy (a test that allows the doctor to view the hernia directly). An esophageal manometry test (pressure study) may also be performed...
You might be able to grit your teeth and learn to live with the discomfort of heartburn. But if you don't treat it, you could end up with serious long-term side effects. Here are just a few complications that can occur with uncontrolled heartburn.
Esophagitis, Barrett's Esophagus, and Esophageal Cancer
When stomach acids repeatedly back up into the esophagus, they can injure its sensitive lining. That injury can lead to painful inflammation called esophagitis. Eventually, the acid wears away at the esophagus, causing bleeding. If the bleeding is heavy enough, blood can pass into the digestive tract and show up as dark, tarry stools. Esophagitis can also cause ulcers -- painful, open sores on the lining of the esophagus.
In a small percentage of people, long-term acid exposure from GERD leads to a condition called Barrett's esophagus (BE). In BE, new cells form to take the place of those damaged by acid reflux. These new cells, however, are abnormal and have the potential to turn cancerous.
The more frequent and severe your heartburn and other reflux symptoms are, the greater the likelihood of developing esophageal cancer. Having severe heartburn at night might make people especially prone to developing cancer. One study found that nighttime heartburn sufferers were nearly 11 times more likely to develop cancer of the esophagus than those without heartburn.
Narrowing of the Esophagus
Damage to the esophagus over time also can produce scarring -- strictures -- that narrow the opening of the esophagus. These narrowed passages can make swallowing difficult and interfere with food and liquids getting into the stomach. It can also cause esophageal spasms, painful chest pains that can mimic a heart attack. As unpleasant as they can be, however, strictures actually have one upside: people who develop them find some relief from their heartburn. That's because the narrowing blocks acids from rising up into the esophagus.
Asthma and Other Respiratory Problems
Asthma and heartburn often go hand-in-hand. Studies have found that about 30% to 80% of patients with asthma also have symptoms of GERD. Whether asthma leads to GERD or vice versa is still unknown. One possible explanation of the connection between GERD and asthma is that acid that backs up from the stomach gets into the airways.
GERD has also been linked to several other respiratory conditions, including: