Effects of uncontrolled heartburn

For most people, the painful burning sensation in the chest that they get 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 gastro-oesophageal reflux disease ( GORD). GORD results from the improper working of the ring of muscle that normally keeps food and acids inside the stomach. When it does not work correctly, it allows acids to come back up into the oesophagus.

You might be able to grit your teeth and learn to live with the discomfort of heartburn. But if you do not treat it, you could end up with serious long-term side effects. Here are just a few of the complications that can occur with uncontrolled heartburn.

Oesophagitis and cancer

When stomach acids repeatedly come back up into the oesophagus, they can injure its sensitive lining. That can lead to a painful inflammation called oesophagitis. Eventually, the acid wears away at the oesophagus, causing bleeding. If the bleeding is heavy enough, blood can pass into the digestive tract and show up as dark, tarry stools. Oesophagitis can also cause ulcers - painful, open sores - on the lining of the oesophagus.

In a small percentage of people, long-term acid exposure from GORD leads to a condition called Barrett's oesophagus. With Barrett's oesophagus, new cells form to take the place of those damaged by acid reflux. But these new cells are abnormal and have the potential to turn cancerous.

Narrowing of the oesophagus

Damage to the oesophagus over time can also produce scarring (strictures) that narrows the opening of the oesophagus. These narrowed passages can make swallowing difficult and interfere with food and liquids getting into the stomach. As unpleasant as they can be, strictures actually have one upside: people who develop them find some relief from their heartburn. This is because the narrowing blocks acids from rising up into the oesophagus.

Asthma and other respiratory problems

Asthma and heartburn often go hand-in-hand. Studies in the US have found that about 30% to 80% of patients with asthma also have symptoms of GORD. Whether asthma leads to GORD or vice versa is still unknown. One possible explanation of the connection between GORD and asthma is that acid that backs up from the stomach gets into the airways.

GORD has also been linked to several other respiratory conditions including:

• Chronic bronchitis
• Chronic cough
• Chronic sinusitis
• Emphysema
• Pulmonary fibrosis (lung scarring)
• Recurrent pneumonia

Voice and throat problems

Acids from GORD 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 GORD.