Gastro-oesophageal reflux disease

Complications of gastro-oesophageal reflux disease

Oesophageal ulcers

The excess acid produced by gastro-oesophageal reflux disease (GORD) can damage the lining of your oesophagus (oesophagitis) which can lead to the formation of ulcers. The ulcers can bleed, causing pain and making swallowing difficult. Ulcers can usually be successfully treated by controlling the underlying symptoms of GORD.

Medications used to treat GORD can take several weeks to become effective, so it is likely your GP will recommend additional medication to provide short-term relief from your symptoms.

Two types of medication that can be used are:

  • antacids to neutralise stomach acid on a short-term basis
  • alginates, which produce a protective coating on the lining of your oesophagus

Both antacids and alginates are over-the-counter medications available from pharmacists. The pharmacist will advise you on the types of antacid and alginate most suitable for you.

Antacids are best taken when you have symptoms, or when symptoms are expected, such as after meals or at bedtime. Alginates are best taken after meals.

Side effects for both medications are uncommon but include:

Oesophageal stricture

Repeated damage to the lining of your oesophagus can lead to the formation of scar tissue. If the scar tissue is allowed to build up, it can cause your oesophagus to become narrowed. This is known as oesophageal stricture.

An oesophageal stricture can make swallowing food difficult and painful. Oesophageal strictures can be treated by using a tiny balloon to dilate (widen) the oesophagus. This procedure is usually carried out under a local anaesthetic.

Barrett’s oesophagus

Repeated episodes of GORD can lead to changes in the cells lining of your lower oesophagus. This is a condition known as Barrett’s oesophagus.

It is estimated that 1 in 10 people with GORD will develop Barrett’s oesophagus. Most cases of Barrett’s oesophagus first develop in people aged 50-70 years old. The average age at diagnosis is 62.

Barrett’s oesophagus does not usually cause noticeable symptoms other than those associated with GORD.

The concern is that Barrett’s oesophagus is a pre-cancerous condition. This means that while changes in the cells are not cancerous, there is a small risk they could develop into ‘full blown’ cancer in the future. This would then trigger the onset of oesophageal cancer (see below).

Oesophageal cancer

Risk factors that increase the risk of cells in the lining of your oesophagus turning cancerous include:

  • being male
  • having the symptoms of GORD for longer than 10 years
  • having three or more episodes of heartburn and related symptoms a week
  • smoking
  • obesity

If it is thought that you have an increased risk of developing oesophageal cancer, it is likely you will be referred for regular endoscopies to monitor the condition of the affected cells.

If oesophageal cancer is diagnosed in its initial stages, it is usually possible to cure the cancer using a treatment called photodynamic therapy (PDT).

PDT involves injecting your oesophagus with a medication that makes it sensitive to the effects of light. A laser attached to an endoscope is then placed inside your oesophagus and burns away the cancerous cells.

Read more about the treatment of oesophageal cancer.

 

Last updated: 22 October 2012