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GERD: Is the Damage Reversible?

Overview

Gastroesophageal reflux disease (GERD) is a chronic condition that affects nearly 20 percent of American adults. People with GERD spend billions on over-the-counter and prescription medications to combat painful heartburn.

While most people experience occasional heartburn, GERD is a chronic condition with symptoms that can occur daily. GERD can cause serious complications over time if it’s left untreated. But can treating it reverse the damage caused by GERD?

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Causes

What causes GERD?

When a person swallows, a complex set of muscles in the mouth and tongue close off the windpipe to protect the lungs and move the food into the esophagus (a narrow tube connecting the throat to the stomach).

At the bottom of the esophagus is a ring of muscles known as the lower esophageal sphincter (LES). A healthy LES relaxes enough to allow food from the esophagus into the stomach. However, in people with GERD, the LES relaxes too much and allows stomach acid to enter the esophagus. This can cause a painful burning sensation in the mid-abdomen, chest, and throat.

While the stomach has a tough lining to protect it from acid, the esophagus doesn’t. So, the sensitive esophageal tissue may be injured over time. The acid often also backs up into the mouth, damaging other structures along the way.

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Complications

Complications

Complications of GERD may include:

  1. Barrett's esophagus
  2. erosive esophagitis
  3. esophageal stricture or narrowing of the esophagus
  4. dental disease
  5. asthma flare-ups

Symptoms can be serious, especially in older people. They may include a severely inflamed esophagus and swallowing difficulties.

Barrett's esophagus

Barrett’s esophagus is most often caused by irritation from GERD. Someone with Barrett’s esophagus is at risk for esophageal cancer due to abnormal, precancerous changes in the cells of the esophagus. According to the National Institute of Diabetes and Digestive and Kidney Diseases, only a small percentage of people with GERD develop Barrett’s esophagus. The average age for diagnosis is 55, and it’s more common in men.

A person with Barrett’s esophagus is between 40 to 50 times more likely to develop esophageal cancer than those who don’t. Severe and longstanding GERD, obesity, smoking, and low intake of fruit and vegetables are risk factors for Barrett’s esophagus.  

Erosive esophagitis

Acid irritation and inflammation can injure the esophagus over time, creating a condition known as erosive esophagitis. People who are obese (especially obese white men) are at the greatest risk of developing erosive esophagitis.

Some people with the condition experience bleeding. This can be seen in dark-colored stools, as well as vomit that looks bloody or like coffee grounds. Ulcers in the esophagus can cause long-term bleeding, which may result in iron-deficiency anemia. This is a serious condition that requires immediate attention and ongoing care.

Stricture

The esophagus may become severely injured over time. This can result in scarring and the development of a narrowed, band-like area known as a stricture. A stricture may result in dysphagia (impaired swallowing). Strictures typically require treatment.

Dental disease

Erosion of tooth enamel from acid backing up into the mouth can occur. People with significant GERD also have more gum disease, tooth loss, and mouth inflammation, likely due to ineffective saliva.

Asthma flare-ups

There is a connection between GERD and asthma. The two conditions often appear together. The reflux of acid into the esophagus may trigger an immune response, making the airways more irritable. Small amounts of acid may also end up in the mouth and then be inhaled. This would also cause airway inflammation and irritation. These processes can trigger asthma flare-ups and make asthma more difficult to control.

Asthma medications and asthma flares can also relax the LES, making GERD symptoms worse in some people.

People with GERD are at an increased risk for other respiratory and throat conditions, including:

  • chronic laryngitis
  • chronic cough
  • granulomas, or pink bumps on the vocal cords
  • hoarse voice and difficulty speaking
  • aspiration pneumonia (often recurring and serious)
  • idiopathic pulmonary fibrosis, or lung scarring
  • sleep disorders
  • constant throat clearing
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Damage reversal

Reversing the damage

Most people with GERD have mild symptoms that can be treated successfully by lifestyle changes, such as:

  • quitting smoking
  • losing weight
  • eating smaller portions at meals

Also, avoiding certain foods that trigger GERD symptoms can provide relief. Foods to decrease or avoid can include:

  • alcohol
  • citrus fruits
  • caffeine
  • coffee
  • colas and other carbonated beverages
  • chocolate
  • fried and fatty foods
  • garlic
  • onions
  • peppermint
  • spearmint
  • tomato sauce

Lifestyle changes usually allow the body to heal itself in the majority of cases, and it means there won’t be long-term damage to the esophagus, throat, or teeth. However, sometimes lifestyle changes are not enough.

More serious cases of GERD can often be treated with medications such as:

Surgery can be an effective treatment for significant GERD in people who don't respond to other treatments. Once GERD symptoms are under control, no further damage to the esophagus, throat, or teeth should occur.

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Outlook

Outlook

While GERD can be a painful disturbance to your lifestyle, it doesn’t affect your lifespan. Those who can manage their symptoms effectively will have a healthier and improved quality of life.

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