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What will happen if I don't treat my acid reflux?

Dr. Jonathan E. Aviv, MD
Ear, Nose & Throat (ENT Specialist)

Left untreated, acid reflux disease can lead to many issues; it can affect the lungs/vocal cords, the nose/sinuses, and can even lead to esophageal cancer. Watch otolaryngologist Jonathan Aviv, MD, explain why it's vital to treat acid reflux disease.

Longstanding GERD can lead to persistent chest and throat pain, bad breath, and voice changes. There is a small percentage of patients who go on to develop esophageal cancer.

For most people failing to treat GERD will result in a worsening of the symptoms and potentially to complications from the constant burning of the esophagus with acid. Most patients over time will develop a hiatal hernia or stomach herniation in which the stomach slips up through the diaphragm into the chest cavity. The hernia usually worsens the symptoms of GERD, but even by itself the hernia can result in trouble swallowing and eating. The constant burning will create a stricture or narrowing of the esophagus making it difficult to swallow. There are many potential problems that may arise from not treating your GERD and it's wise to discuss this with your primary care physician.

If you don't treat gastroesophageal reflux disease (GERD), complications can occur. These include ulcers, bleeding, and anemia (low blood count). Long-term GERD can also lead to scarring and narrowing of the esophagus (stricture), making it difficult to swallow, and Barrett's esophagus, which is a serious change in the cells lining the esophagus. If you have symptoms, see your doctor. Treatment can usually prevent these complications.

Modern reflux medications are making complications less common, but untreated reflux disease can still do a lot of harm. In this video, Sharmila Anandasabapathy, MD, a gastroenterologist, discusses those complications.

Complications of acid reflux can include dysphagia (difficulty swallowing), regurgitation and an increased risk of cancer. This is due to progressive damage to the esophagus, resulting in inflammation, ulceration and possible scarring with narrowing. In addition, these symptoms may be indicative of esophageal cancer. All of these symptoms merit seeing a doctor for further care. At that time, the individual should undergo an upper endoscopy to evaluate the source of the problem. Barrett's esophagus is a condition where the lining of the esophagus changes because of chronic inflammation, generally due to GERD. In the setting of chronic acid exposure, the cellular structure of the lower esophageal lining changes to look more like the cells lining the intestine. Barrett's esophagus itself has no specific symptoms, but this change can increase the risk of esophageal adenocarcinoma (a type of esophageal cancer). Barrett's esophagus can be readily detected during an upper endoscopy but must be confirmed by biopsies. The intent is to diagnose this condition, treat it medically and follow it over time before cancer has a chance to develop. If biopsies detect dysplasia (a precancerous change in tissue), then your doctor will recommend either close endoscopic surveillance (doing endoscopies at regular intervals with biopsies), endoscopic therapy or surgery. Endoscopic therapy may include removal of Barrett’s with dysplasia using endoscopic mucosal resection, which can remove abnormal tissue in the esophagus without damaging the rest of the esophagus. Endoscopic ablation of Barrett’s tissue can be done with either radiofrequency ablation, which destroys and kills cells by heating them, or cryotherapy, which destroys cells by freezing them. After treatment, the esophagus grows back a normal healthy lining. Your physician will determine which treatment option is best for you.

First off, acid reflux disease (GERD) can be very uncomfortable to live with. Without treatment the symptoms will only get worse. You could develop narrowing of the esophagus, which makes it more difficult to swallow. Acid reflux disease can also lead to painful inflammation in your esophagus, an increased risk of esophageal cancer, asthma, recurring pneumonia and lung scarring.

Occasional reflux symptoms are typically not a cause for concern, but having daily or even weekly symptoms can result in repeated exposure of the lower part of your esophagus to erosive stomach acid. If left untreated, this chronic exposure of stomach acid can lead to a number of problems, including ulcers, strictures, daily pain or discomfort, and difficulty swallowing. It can even lead to changes in the cells lining the esophagus, a syndrome known as Barrett’s esophagus. Roughly 10 to 20 percent of people with gastroesophageal reflux disease (GERD) go on to develop this disease.

Dr. Vijay K. Nuthakki, MD
Cardiothoracic Surgeon

Gastroesophageal reflux is commonly due to migration of acid from the stomach back up into the esophagus. Reflux can cause heartburn or be asymptomatic. If not treated, this acid exposure can cause inflammation in the esophagus as well as pain. Reflux can progress up to the mouth, causing a sour taste, cough, or even pneumonia if it spills into the airway. Prolonged exposure can lead to strictures, or development of intestinal metaplasia (Barrett's esophagus). This could progress to dysplasia and cancer of the esophagus.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.