Complications of reflux

Oesophagitis

An inflammation of the lining of the oesophagus that can range from inflamed mucosa (inner lining of the oesophagus) to erosive ulcers. Gastrointestinal bleeding may occur from these damaged areas. It is similar to a chemical burn.

Oesophageal Ulcers

Significant burning by gastric juice causes loss of mucosa and can lead to the formation of oesophageal ulcer.

Oesophageal Stricture

Repeated damage to the lining of the oesophagus may lead to scar tissue formation and eventually to narrowing of the oesophagus. This can cause difficulty swallowing and should be investigated to rule out malignancy. Treatment for oesophageal stricture can include stretches or “dilatation”.

Barrett’s Oesophagus

Repeated reflux can lead to changes in the cells that line the lower oesophagus. This is known as Barrett’s oesophagus.  It is estimated that 1 in 10 people with GORD will develop the condition.  
Barrett’s oesophagus, in itself, does not  cause any noticeable symptoms.  However, the condition is important because in some patients it is a precursor to cancer. The risk is small, but significant. For men with Barrett’s the lifetime risk developing cancer is about 5% and women 3%. For this reason, patients that are diagnosed with Barrett’s oesophagus may be offered regular endoscopies (every 2-3 years) to ensure that the cells have not changed.

Oesophageal cancer

Oesophageal cancer remains relatively rare but over the last 30 years its incidence in the western world has increased dramatically. The overwhelming majority of cases are associated with Barrett’s oesophagus, which in turn is reflux related. There is evidence that the more symptoms of reflux people experience the more likely they are to develop cancer. It is estimated that each year in England 1 in 200 people with Barrett’s oesophagus will develop oesophageal cancer. It is important to remember that reflux is very common and oesophageal cancer is rare; however, the two are undoubtedly related. For this reason patients who develop reflux may be referred for investigation to rule out malignancy.

Barretts Oesophagus

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Oesophagitis

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Stricture

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