Long-Term Effects of Acid Reflux
Acid reflux occurs when the contents of your stomach rise into your esophagus, toward your throat. The most common symptoms of acid reflux are heartburn and regurgitation. Because some of the most effective medications for treating acid reflux are available over the counter, many people with acid reflux self-diagnose and self-treat and delay seeing their physicians. If you have persistent acid reflux, you could develop serious complications.
Acid Reflux or GERD?
The distinctions between acid reflux – otherwise known as gastroesophageal reflux, or GER – and full-blown gastroesophageal reflux disease are not always clear-cut. GER is characterized by occasional heartburn or regurgitation and is a very common condition. GERD is diagnosed when your heartburn recurs frequently, when you develop “extra-esophageal” symptoms, such as a chronic cough, hoarseness or a persistent sore throat, or when evidence of acid-induced esophageal injury is discovered during endoscopy, which is performed by passing a scope down your esophagus.
One potential complication of ongoing acid reflux is esophagitis. This condition is characterized by acid-induced inflammation in the lower end of your esophagus, and it can be diagnosed during endoscopy. Many people with esophagitis – but certainly not all – experience excruciating pain during acid reflux episodes. Some patients with esophagitis develop erosions, or ulcerations, in their esophagus. This condition is called erosive esophagitis. Esophageal erosions, just like ulcers in your stomach, are prone to bleeding, making anemia a possible complication of erosive esophagitis.
If you develop esophagitis that isn’t appropriately treated, you could be at risk for esophageal scarring and stricture or narrowing. The initial symptom of an esophageal stricture is discomfort – often described as a “sticking” sensation – when swallowing solid foods. As your esophagus becomes even narrower, you may experience difficulty swallowing soft foods or even liquids. A 2010 review in the World Journal of Gastrointestinal Endoscopy reported that up to 10 percent of patients with esophagitis develop strictures. This complication is particularly prevalent in elderly men. Strictures can be treated by dilating, or widening, your esophagus, but they may recur.
Normally, the cells lining your lower esophagus are unlike those that line your stomach. Esophageal cells are typically flatter, and they don’t produce as much mucus as stomach cells. When your lower esophagus is continually exposed to acid, however, its cells undergo changes that make them look more like the cells in your stomach. This condition, Barrett’s esophagus, sets the stage for esophageal cancer. Barrett esophagus and esophageal cancer are more common in the elderly, but both conditions can occur in younger people, too. Like esophagitis, Barrett esophagus and esophageal cancer can be diagnosed with endoscopy.
A number of other complications can develop in people with long-term acid reflux. After postnasal drip syndrome and asthma, GERD is the most common cause of chronic cough. Sinusitis, recurrent ear infections, chest pain, sleep disruption, laryngitis, eroded dental enamel, narrowing of the windpipe and even laryngeal cancer have been linked to chronic acid reflux.
Proton pump inhibitors, such as omeprazole (Prilosec) and lansoprazole (Prevacid), are the most commonly used medications for acid reflux and GERD. PPIs are available over the counter and by prescription. These medications inhibit stomach acid production and are effective for most people with acid reflux. If you have persistent heartburn despite taking OTC medications, see your doctor for an evaluation.