Everyone gets heartburn from time to time, and most will not experience any problems beyond discomfort. However, having heartburn several times per week can cause damage and irritation to the esophagus over time. If left untreated, this can eventually lead to an increased risk of more serious conditions like strictures, ulcers, and even esophageal cancer.
If the muscle that keeps acid in the stomach and out of the esophagus is weak or damaged, acid can flow back into the esophagus and cause damage and irritation. Damage is more likely when you have acid reflux 2-3 times a week or more. Acid reflux becomes GERD (gastroesophageal reflux disease) if the symptoms are bothersome or it causes damage to the esophagus. About 20% of the population is affected by GERD.
When stomach acid flows back into the esophagus and causes damage, it can include ulcers and erosions. These ulcers have the potential to bleed and cause long-term damage to the esophagus when they repeatedly heal and re-develop.
Damage caused by acid reflux can cause the esophagus to scar and narrow. This is called stricture. Over time, stricture could cause a blockage of food and require treatment. The scar tissue is a result of ulcers that occur and heal over time.
Over time, chronic acid reflux (GERD) can cause changes in the lining of the esophagus walls. Frequent exposure to stomach acid causes cells in the esophagus to change. The new cells are similar to what is found in the stomach and small intestines. Barrett’s esophagus does not have symptoms, but because it’s related to GERD, the symptoms of Acid Reflux (e.g. Chronic Heartburn) are often present.
Barrett’s esophagus is a major risk factor for developing esophageal cancer. The rate of esophageal cancer is on the rise, but relatively few people with GERD develop Barrett’s esophagus and even fewer people with Barrett’s esophagus develop esophageal cancer.
If you have heartburn at least 2 times a week, we recommend an appointment with a gastroenterologist. They can help diagnose the root cause of your heartburn and recommend a treatment plan.
Many patients find relief from heartburn through lifestyle changes and medications. Some are available over-the-counter.
Antacids may provide short-term relief from acid reflux. They are available over the counter and include products like Tums®, Maalox®, and Mylanta®.
Histamine antagonists reduce acid production in the stomach, but may not be as effective as proton pump inhibitors.
Histamine antagonists available in the US include ranitidine (Zantac®), famotidine (Pepcid®), cimetidine (Tagamet®), and nizatidine (Axid®).
Changes in diet and lifestyle may be effective for some people. You may decide to try these before seeking medical treatment for mild symptoms of acid reflux. If you have severe symptoms, you should be evaluated by a doctor for treatment.
See article: 10 Ways to Avoid Heartburn at Home
Most people with moderate to severe acid reflux are treated with proton pump inhibitors (PPIs). PPIs include omeprazole (Prilosec®), esomeprazole (Nexium®), lansoprazole (Prevacid®), dexlansoprazole (Kapidex®), pantoprazole (Protonix®), and rabeprazole (Aciphex®).
A typical PPI treatment lasts 8 weeks. Using the lowest possible dose of these medications that manage symptoms or prevents complications is the best strategy.
If your symptoms are not managed by a PPI, your doctor may recommend a different PPI or using a stronger dose. Additional testing may be necessary to determine the next course of treatment.
Not sure what to do about your acid reflux? Schedule an appointment today.
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