The holiday season brings many opportunities for indulgence with hearty meals, special cocktails, and extra sweets. For some, season’s greetings may also come with increased incidences of heartburn. But when does heartburn go from a periodic discomfort to something far more serious?
“Heartburn, or acid reflux, is characterized by a burning feeling in the chest or throat caused by stomach acid backed up in the esophagus, which moves food from your mouth to stomach,” explained Dr. Jigar Patel, MD, a gastroenterologist with Memorial Hermann Medical Group (MHMG). “When a flaw causes the lower esophageal sphincter—a valve that connects the esophagus and stomach—to not tighten properly, stomach acid can flow back into the esophagus and cause a burning feeling.”
Many people experience heartburn from eating acidic or fatty foods, like coffee and chocolate, as well as large meals eaten just prior to laying down or drinking excessively. For many, this is an occasional discomfort. However, for those who experience heartburn on a regular basis, it can develop into something more dangerous.
Below are a few of the complications that can result from uncontrolled or untreated heartburn:
Esophagitis, Barrett’s Esophagus, and Esophageal Cancer
When stomach acid backs up in the esophagus repeatedly, it can injure the esophagus lining. This can lead to inflammation called esophagitis. This irritation can be very painful and, over time, could lead to bleeding of the esophagus and ulcers on the esophagus lining.
“In very serious cases, long-term acid exposure can cause abnormal cells to form to replace those damaged by the acid,” Patel said. “People who have this condition, called Barrett’s Esophagus, have an increased risk for esophageal cancer.”
Luckily, Patel said, Barrett’s Esophagus is treatable if caught early. According to the American College of Gastroenterology guidelines, men with chronic (more than five years) or frequent (weekly or more) symptoms of gastroesophageal reflux, coupled with two or more risk factors, should be screened. These risk factors include family history, presence of obesity, a history of smoking, and individuals who are Caucasian and over the age of 50.
Other Esophageal Issues
The continual exposure of the esophagus to stomach acid can lead to scars, otherwise known as strictures, that can cause the esophagus to narrow over time. This can make it more difficult to swallow or even cause spasms, which are very painful and have been likened to the sensation of a heart attack.
Dental and Respiratory Problems
Studies have shown that 30 to 80 percent of patients with asthma also have gastroesophageal reflux disease (GERD), which has a primary symptom of heartburn. Some believe that many respiratory complications are caused by stomach acid that has backed up into the esophagus and subsequently has entered the airways, leading to asthma, emphysema, chronic bronchitis and recurrent pneumonia.
Similarly, the stomach acid entering the mouth can severely damage teeth and injure tooth enamel, causing greater dental erosion.
While these conditions can be serious, the greatest threat is if heartburn is left untreated for a long period of time.
“If you are experiencing regular heartburn and lifestyle interventions are not helping, meet with your doctor,” Patel said. “There are treatments available that can ease heartburn symptoms and reduce the risk for further complications.”