Quite often, you may come across people complaining about heartburn. It's a normal occurrence and we generally choose to take it very lightly. We commonly prefer to refer it as a "harmless" case of indigestion, but is it?
Acid reflux is caused when your stomach acid pushes up the barrier between the stomach and the esophagus and reaches the esophagus (food pipe) causing heartburn by its "acidic character". It's not as simple as it seems especially when it becomes persistent with frequent relapses. Your esophagus is not meant to tolerate "acidic caress" over and over. An untreated gastro reflux disease invites a number of complications including:
- Erosive Esophagitis: This is the most common complication associated with a long term prevalence of the disease. Esophagitis is an inflammation and swelling of the esophagus and is most often caused by acid-containing stomach contents refluxing back up into the esophagus. The risk of erosive esophagitis increases with the duration and the severity of the condition.
- Esophageal Ulcers: An ulcer is simply a breakage in the lining of the esophagus. It occurs in an area of inflammation. Ulcers and the additional inflammation they provoke may erode the esophageal blood vessels and may cause esophageal bleeding. Occasionally, the bleeding may be severe and may require blood transfusion, an endoscopic procedure or a surgical treatment.
- Strictures: Ulcers of the esophagus heal with the formation of scars (fibrosis). Over time, the scar tissue shrinks and narrows the lumen (inner cavity) of the esophagus. This scarred narrowing is called a stricture and it increases the risk of swallowing problems.
- Barrett's Esophagus: Barrett's esophagus is a condition in which the esophagus, the muscular tube that carries food and saliva from the mouth to the stomach, changes due to which some part of its lining is replaced by a type of tissue similar to what is normally found in the intestine. Those with Barrett's esophagus are 30 to 125 times more likely to develop esophageal cancer than those without this condition.
- Esophageal Cancer: Esophageal cancer may result due to the formation of malignant (cancer) cells in the tissues of the esophagus. Doctors cannot always explain why one person gets cancer and another does not. There is, however, a strong association between gastroesophageal reflux disease (GERD) and esophageal cancer. It is of two types:
- Squamous Cell Carcinoma: It begins in the tissues that line the esophagus and it is usually found in the upper or middle esophagus.
- Adenocarcinoma: It may result from Barrett's esophagus. It is more often found in the lower esophagus.
- Laryngeal Cancer: Researchers have reported that GERD is significantly associated with the development of laryngeal cancer (cancer of the larynx - the area where the vocal cords are located).
- Asthma and Cough: Between 32 to 80 percent of the asthma cases coincide with reflux disorder, according to several studies. Coughing, shortness of breath and other asthma symptoms can result when stomach acid enters the airways as a result of acid reflux. In turn, some asthma medications aggravate GERD symptoms. An asthma attack changes the airway pressure, which may relax the esophageal sphincter, thereby causing acid reflux.
- Inflammation of Throat and Larynx: If the refluxed liquid gets past the upper esophageal sphincter, it can enter the throat (pharynx) and even the voice box (larynx). The resulting inflammation can lead to a sore throat and hoarseness of voice.
- Inflammation and Infection of the Lungs: The refluxed liquid that passes the larynx can enter the lungs as well. The reflux of liquid into the lungs (called aspiration) often results in coughing and choking. Aspiration, however, can also occur without producing these symptoms. With or without these symptoms, aspiration may lead to infection of the lungs and result in pneumonia. When aspiration is unaccompanied by symptoms, it can result in a slow, progressive scarring of the lungs (pulmonary fibrosis) that can be seen on chest x-rays.
- Accumulation of Fluid in the Sinuses and Middle Ears: The throat communicates with the nasal passages. In small children, two patches of lymph tissue, called the adenoids are located in a position where the upper part of the throat joins the nasal passages. The refluxed liquid that enters the upper throat can cause the adenoids to swell and this can block the passages from the sinuses and the Eustachian tubes due to which the fluid accumulates within them. This accumulation of fluid can lead to discomfort in the sinuses and ears. Since the adenoids are prominent in young children and not in adults, this fluid accumulation in the ears and sinuses is seen in children and not adults.
- Dental Problems: Dental erosion (the loss of the tooth's enamel coating) is a very common problem among GERD patients including children. It results from the acid backing up into the mouth and eroding the enamel making them more vulnerable to cavities.
- Sleep Apnea: GERD commonly occurs with obstructive sleep apnea, a condition in which breathing stops temporarily but repeatedly during sleep. It is not clear which condition is responsible for causing the other, but GERD is particularly severe when the both conditions occur together. One study reported that spasms in the vocal cords caused by acid reflux may block the flow of air and cause sleep apnea in adults.
It is a common phenomenon to experience the shooting up of the stomach acid once in a while. But it is not so common to get heartburn every alternate day. If this is the case with you, don't take it as a simple case of indigestion or acidity. You definitely cannot allow your system to get an "acidic cleanse".
