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 a valve, called the lower esophageal sphincter (LES), that normally keeps food and acids inside the stomach. When it doesn't work correctly, it allows acids to back up into the esophagus.
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, abnormal cells form and take the place of the cells damaged by acid reflux. And these cells have the potential to turn cancerous.
Those with BE have an increased risk of esophageal adenocarcinoma, or cancer of the esophagus. The probability for cancer is greater in white males over the age of 50, as well as in those who smoke or who are obese. If you are experiencing severe, long term heartburn, call you doctor.
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, people who develop strictures 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:
- Chronic bronchitis
- Chronic cough
- Chronic sinusitis
- Pulmonary fibrosis (lung scarring)
- Recurrent pneumonia
Voice and Throat Problems
Acids from GERD can affect the throat, leading to hoarseness and laryngitis. Some people, particularly those with very severe acid reflux, have reported voice changes. On a positive note, voice and throat problems tend to respond very well to treatment for GERD.
Dental Problems Due to Reflux
When harsh acids make their way into the mouth, they can wreak havoc with tooth enamel. A number of studies have noted that people with GERD have more dental erosion than normal. The condition can also lead to bad breath and an increase in saliva production.
Heartburn Complications in Children
Infants and children can also develop heartburn and other symptoms of GERD. Although they might not be able to express exactly what they're feeling, they can eventually develop many of the same complications as adults if the condition isn't treated. Infants with severe reflux may fail to feed properly. This, in turn, leads to poor growth. If they aspirate stomach acids into the airways, babies can develop recurrent pneumonia. Some researchers have even suggested that sudden infant death syndrome might be related to a blockage of the airways due to reflux.
Avoiding Complications of Reflux
Before you worry that your heartburn is leading you straight down the road to esophagitis or esophageal cancer, you should know there are several treatments available. These treatments can both ease your heartburn and reduce your risk for complications.
A gastroenterologist can often use a thin scope called an endoscope to look at your esophagus and diagnose your condition. There are also other test she can use to help with the diagnosis. Treatment for GERD usually involves medications and lifestyle interventions. On rare occasions, however, surgery may be needed to relieve a blockage or prevent the acid from backing up.