Heartburn (Pyrosis): Complications

The following are the most important diseases or complications that may be contributed to by pyrosis (heartburn):

Respiratory system (J00-J99)

Bronchial asthma (reflux asthma) Note: Successful reflux therapy for bronchial asthma may reduce the need for long-term therapeutic agents!
Bronchial obstruction (narrowing (obstruction) of the bronchi).
Chronic cough
Chronic laryngitis (inflammation of the larynx)
Chronic obstructive pulmonary disease (COPD) exacerbation (marked worsening of symptoms; when not taking proton pump inhibitors (PPI; acid blockers)).
Chronic pharyngitis (pharyngitis).
Chronic sinusitis (sinusitis) → sinubronchitis
Chronic tracheobronchitis – inflammation of the trachea and large bronchi.
Recurrent pneumonia (pneumonia) in infants.

Blood, blood-forming organs – immune system (D50-D90).

Endocrine, nutritional, and metabolic diseases (E00-E90).

Angina pectoris (“chest tightness”; sudden onset of pain in the cardiac region) or pectanginal discomfort (chest pain) (due to reflux-related irritation of the vagus nerve → coronary spasm/contraction of the coronary arteries)
Atrial fibrillation (VHF) (probably due toreflux-related irritation of the vagus nerve).

Mouth, esophagus (food pipe), stomach, and intestines (K00-K67; K90-K93).

Barrett’s esophagus – changes in the mucosa due to replacement of squamous epithelium by cylindrical epithelium; this change is considered a facultative (possible) precancerous condition (precancerous stage) for adenocarcinoma (incidence (frequency of new cases) of 1.2/1. 000 patient-years and a relative risk of 11.3; compared with the normal population: 8.8-14.4, this means that the risk of developing adenocarcinoma in the presence of Barret’s esophagus is much lower than previously thought.Risk factors for this are:
- Higher age (three percent per additional year of life).
- Male gender (2.2 times)
- Smoking (+ 47%)
- Longer lesion segments increased the risk of progression to Barrett’s esophagus (for each additional centimeter, the risk of progression increased by 25%)
- Presence of low-grade dysplasia
Burning mouth syndrome (BMS) (synonyms: glossalgia, glossodynia, glossopyrosis) – burning of the tongue and oral mucosa.
Dental erosions (loss of tooth structure).
Gingivitis (inflammation of the gums)
Hypersensitive esophagus – present when reflux events are formally quantitatively within the norm, but perceived as heartburn with positive symptom index.
Reflux esophagitis – esophagitis caused by the constant reflux (reflux) of gastric juice; this may be accompanied by bleeding, ulceration (ulceration) and adhesions, leading to stenosis (narrowing) or strictures (high-grade constriction)
Tooth erosions

Neoplasms – tumor diseases (C00-D48)

Head and neck tumors occurred more frequently in patients with gastroesophageal reflux disease (GERD):
- Laryngeal carcinoma (cancer of the larynx) 2.86 (95 percent confidence interval 2.65-3.09).
- Carcinoma of the hypopharynx (“cancer of the lower pharynx”) 2.54 (1.97-3.29)
- Carcinomas of the oropharynx (“cancer of the oral pharynx”) 2.47 (1.90-3.23)
- Carcinomas in the nasopharynx (nasopharyngeal cancer) 2.04 (1.56-2.66)
- Carcinomas of the tonsils (tonsils) 2.14 (1.82-2.53)
- Malignancies of the paranasal sinuses 1.40 (1.15-1.70)
Esophageal cancer (cancer of the esophagus) (men with severe reflux: 6-fold higher risk of dying from adenocarcinoma of the esophagus; women: 3.5-fold higher risk, but statistically significant only in the age group over 60 years)

Ears – mastoid process (H60-H95).

Symptoms and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99)

Injuries, poisonings, and certain other consequences of external causes (S00-T98).