Complications | Reflux

Complications

Ulcer in the esophagus, bleeding, swallowing of stomach contents, especially at night, berett-esophagus (beret syndrome), swallowing disorders due to a narrowing of the esophagus. Iron deficiency anemia may occur due to blood loss. Anemia is sometimes the first symptom, which is why patients consult a doctor at all.

In the beretted esophagus, a transformation (metaplasia) of the epithelium of the esophagus occurs. This syndrome is considered to be a precancerous stage (precancerosis), which is why patients with this disease should have a medical check-up every 3-5 years to see if a cancer has developed. Bronchial asthma and reflux disease are closely related, and a correlation between the two can often be found in about 30% or more.

How exactly this connection exists has not yet been clarified. One theory is that the reflux of gastric juice also reaches the bronchial tubes of the lungs and irritates them strongly. Another assumption is that the acidity of the gastric juice irritates the tenth cranial nerve, nervus vagus, which causes a narrowing of the bronchi.

In the context of a reflux disease, a dentist should often be consulted, as it is easier to damage the enamel. An inflammation of the esophagus can occur as a result of reflux and can be explained by the anatomical conditions in the esophagus and stomach. The esophagus is made of a different type of mucous membrane than the stomach.

In the esophagus there is a so-called “squamous epithelium“. It is a simple layer that only passes on food pulp and has no other functions. The stomach in turn contains a so-called “cylindrical epithelium“.

This mucosa has the ability to protect itself from gastric acid by producing a protective film. If stomach acid enters the esophagus during reflux, the epithelium there cannot protect itself from the acid in the digested food pulp. The consequence is that its surface is irritated by the acid.

The structure of the mucous membrane is lost with increased contact and an inflammation of the affected areas occurs. Symptomatically, this process manifests itself in heartburn and even pain during and after eating. The inflammation will only be able to subside if renewed contact with stomach acid is prevented.

The development of a laryngitis is rarely observed in reflux. However, it is quite possible in a high-grade reflux. In this case, however, the digested food must reach just before the throat area.

The epiglottis is anatomically located between the throat and the trachea. In a reflux, this means that the patient feels the rising of the food in the form of a strong heartburn in the throat and a simultaneous feeling of regurgitation. This means that the food can sometimes re-enter the mouth and imitate a weakened vomiting.

The mucous membrane of the larynx can then be irritated by the stomach acid. With increased contact, the surface structure of the mucous membrane can then be increasingly attacked, resulting in inflammation. For those affected, this manifests itself in a burning sensation when swallowing or breathing.

Furthermore, pain is typical when swallowing food in the neck area.The voice is not affected by a pure inflammation of the epiglottis. However, if stomach acid passes the epiglottis and enters the windpipe as in swallowing, it can also attack the vocal chords. Those affected could then notice hoarseness as a further symptom.

A reflux often occurs in combination with an inflammation of the stomach lining. However, it is important to know that they do not necessarily require their simultaneous presence. Rather, they are to be regarded as two independent clinical pictures, which can influence each other.

An increased production of gastric acid can destroy the protective film over the gastric mucosa. The consequence is irritation of the mucous membrane, which can become inflamed if contact is maintained. If the inflammation continues, a painful ulcer may develop.

However, the inflammation of the stomach mucosa does not lead to a functional disorder of the lower sphincter muscle of the esophagus. Other factors such as a diaphragmatic hernia must be present for this to happen. However, if a pathological closing mechanism is present, the increased production of gastric acid can aggravate an existing reflux.

Symptoms such as heartburn or pain during food intake are thus intensified, as more stomach acid can enter the esophagus. The dangerous thing about the combination of these two diseases is that the increased production of stomach acid can cause more damage to the esophagus. The stronger the inflammatory reaction in the esophagus, the more the mucous membrane tends to lose its actual cell structure. The transformation process thus involves the risk of degeneration, which in the worst case can lead to cancer.