Gastroesophageal Reflux Disease (GERD): What Happens

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What Happens

Mild gastroesophageal reflux disease (GERD) may cause irritation or inflammation in the esophagus. This condition is called esophagitis. But some studies indicate that less than half of the people with GERD show signs of esophagitis.^{3 4} GERD without esophagitis is sometimes called nonerosive reflux disease.

If you have mild GERD symptoms—an uncomfortable feeling of burning, warmth, heat, or pain just behind the breastbone, commonly referred to as heartburn—you may be able to successfully treat yourself with nonprescription medicines that reduce or block acid. These include antacids (such as Tums), H2 blockers (such as Pepcid), or proton pump inhibitors (such as Prilosec OTC). Changing your diet, losing weight, and making other lifestyle changes can also help reduce heartburn.

Up to 80% of pregnant women have symptoms of GERD during pregnancy.¹ Heartburn is common during pregnancy because hormones cause the digestive system to slow down. The muscles that push food down the esophagus also move more slowly during pregnancy. In addition, as the uterus grows, it pushes on the stomach and sometimes forces stomach acid up into the esophagus.

Advanced GERD can cause complications such as:

• Severe inflammation of the lining of the esophagus (esophagitis).
• Wearing away (erosion) the lining of the esophagus that may lead to crater-shaped sores (ulcers) in the lining of the esophagus (esophageal erosion and ulcers).
• Narrowing of the esophagus (esophageal stricture).
• Bleeding from the esophagus.
• Barrett's esophagus, in which the cells that line the inside of the esophagus are replaced by cells similar to those that line the inside of the stomach and intestine. Barrett's esophagus is not common, but can lead to cancer of the esophagus.
• Respiratory problems, such as a persistent cough, asthma, or pneumonia.
• Structural changes of the lungs or voice box (larynx). This may be noticeable as increased hoarseness or frequent laryngitis.
• Irritation of the passage that connects the nasal airways to the upper portion of the throat (pharynx), causing pharyngitis.
• The speeding up of tooth decay, because stomach acid gets into the mouth and wears away tooth enamel.

Some people who have GERD may be at increased risk for developing cancer of the esophagus.

Last updated:	March 31, 2008
Author:	Monica Rhodes
Reviewed By:	Kathleen Romito, MD - Family Medicine, Jerome B. Simon, MD, FRCPC, FACP - Gastroenterology
Editors:	Kathleen M. Ariss, MS, Pat Truman, MATC