Heartburn Complications

By Stacey Colino

It’s easy to shrug off heartburn as no more than an uncomfortable inconvenience. But that’s a mistake because if heartburn is frequent and severe, it can lead to serious complications. Surprised?

“Most people don’t realize there can be complications from chronic heartburn,” says Dr. Richard Desi, a gastroenterologist at Mercy Medical Center in Baltimore. Here are four heartburn complications you need to know about:

1. Esophagitis
Repeated exposure to stomach acid can inflame and irritate the lining of your esophagus, a condition called esophagitis. Along with the usual heartburn symptoms, esophagitis can lead to general pain in the throat and pain when swallowing. “It’s one of the most common complications of heartburn,” says Desi.

How it’s treated: Esophagitis is usually treated with antacids or acid-blocking drugs.

2. Ulcers and Bleeding
An ulcer (or sore) can develop in the esophagus if the lining erodes and becomes irritated due to repeated surges of stomach acid into the esophagus. Sometimes the sore bleeds and causes pain, says Desi.

How it’s treated: Long-term use of acid blockers or proton pump inhibitors may be warranted to allow the ulcer to heal.

3. Strictures
An esophageal stricture is a narrowing of the esophagus that occurs when chronic inflammation leads to an excess turnover of cells, resulting in a thickening of the esophageal lining. “Strictures can progress to the point where you have a difficult time eating,” says Desi. You might have trouble swallowing or constantly feel like food is getting stuck on the way down.

How it’s treated: Heartburn medications are the first line of treatment. If they don’t help, it may be necessary to stretch the esophagus through endoscopy (a procedure that involves inserting a flexible tube into the esophagus), says Desi.

4. Barrett’s Esophagus
The most serious of heartburn complications, Barrett’s esophagus is a precancerous condition that can occur with chronic heartburn. Because the esophagus is continuously exposed to surges of stomach acid with chronic heartburn, this can cause chronic inflammation that leads to abnormal cellular changes, explains Desi. In addition, “most people won’t even know they have it, because they’ll just have typical reflux symptoms,” says Desi. The only way to diagnose Barrett’s esophagus is to undergo an upper endoscopy to look for abnormal changes.

How it’s treated: Barrett’s esophagus is treated with continued use of heartburn medications. It’s also important to have regular endoscopies (and possibly biopsies) to see if the condition is progressing to esophageal cancer, which can happen in a small percentage of cases, explains Desi. If the cells become abnormal enough to be labeled “dysplasia,” surgery or radiofrequency ablation (a noninvasive procedure that uses heat to destroy abnormal cells) may be warranted.

So if you suffer from heartburn on a regular basis, don’t blow it off. Consult your doctor to head off possible heartburn complications before they become serious.

Stacey Colino has written for The Washington Post health section and many national magazines, including Newsweek, Real Simple, Woman's Day, Self, Marie Claire, Cosmopolitan, Glamour, Parenting, Sports Illustrated and Ladies' Home Journal.

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