Can prolonged gastric acid reflux damage the food pipe?

The acid from the stomach can enter the esophagus (food pipe) in conditions like gastroesophageal reflux disease (GERD). Gastric acid reflux can cause progressive damage to the esophagus lining, manifesting as a burning sensation, vomiting, and epigastric pain. The unpleasant symptoms can last from a few minutes to several hours. Extraesophageal symptoms can include hoarseness and chronic cough.

Dr. Amit Maydeo, Chairman, Institute of Gastro Sciences, Sir H. N. Reliance Foundation Hospital and Research Centre, Girgaon, Mumbai says, “The lower esophageal sphincter (LES) allows food to travel from the esophagus to the stomach. In GERD, the LES does not close completely, allowing food to return to the esophagus, thereby causing erosions and inflammation of the esophagus. The regurgitation of food into the throat causes a sour taste in the mouth. Reflux is physiologic, which is asymptomatic and short-lived. Pathologic reflux is bothersome as it causes troublesome symptoms and can lead to complications. GERD can have an adverse impact on the quality of life and contribute to the substantial cost of therapy.
The prevalence of GERD in India ranges from 7.6-30%. Every one in four patients do experience such symptoms. The common risk factors include smoking, alcohol consumption, obesity, and dietary factors.

Only poor eating habits are not responsible for acid reflux. Prolonged sleep disorders and Gallstones and cardiac conditions can also cause similar symptoms. Long-term reflux can lead to complications like strictures and Barrett's esophagus (precancerous stage); the treatment varies for different diseases. Psychosocial factors, including stress and anxiety, can also contribute to similar symptoms. The damage to the food pipe can be minimized. Utilizing modest lifestyle changes with a balanced diet, addressing risk factors, practicing portion control, optimal medications, and an individualized approach to anti-reflux endoscopic therapy can help manage GERD.

Lifestyle modifications are initially recommended. This includes bed head elevation by 15-20 cm and sleeping on the left side. The meal portion should be small, and more frequent meals must be consumed. It is best to avoid carbonated beverages, processed food, citrus fruits, fatty and spicy meals that can aggravate GERD symptoms. It is advisable to wait at least 2 hrs before going to bed after dinner.

“Diagnosis is made on clinical symptoms. An upper GI endoscopy helps differentiate GERD and erosive esophagitis and non-erosive reflux disease. Endoscopy is routinely done as a daycare procedure under sedation. The 24-h-pH impedance is used to study reflux episodes (acidic and non-acidic) over 24 hours. Some of the tests are necessary to initiate an appropriate therapy. A biopsy is usually taken during endoscopy to check for Helicobacter Pylori infection. This bacterium is widely present in the stomach, but peptic ulcers and troublesome symptoms need anti-H. Pylori therapy,” says Dr. Maydeo.