Strange GERD Symptoms

Practically everyone has indigestion and heartburn at times, sometimes just from overeating or having too large a bedtime snack. Estimates suggest that from 10 to 15 percent of Americans have frequent indigestion, sometimes as often as once or more times a day. When indigestion becomes this frequent, it is called gastroesophageal reflux disease--GERD. This is a serious condition and can in a small percentage of cases lead to esophageal adenocarcinoma--cancer of the esophagus. Esophageal cancer is one of the the fastest growing cancers in North America. The annual rate has increased over the past 10 years among white males fourfold. The longer GERD persists, the greater the risk, to the point where if someone has GERD for 15 or more years, the risk may be 21.8 times as high. See the MedScape site for more information.

Chronic GERD can result in several significant alterations in the esophagus. One is the formation of a stricture at the end of the esophagus just before it enters the stomach. This stricture, which is the body's attempt to prevent acid from refluxing back up the esophagus, can cause swallowing difficulties accompanied by excess mucous production and violent hiccups or coughs as the system attempts to allow the food to pass into the stomach. Thus, swallowing problems can be one of the symptoms of GERD, or even of a more serious condition.

There are many symptoms connected with GERD besides acid indigestion. These include pain in the neck, throat and face, a dry mouth, frequent cough, and even bleeding from esophagus inflammation, in which case the blood may either be regurgitated or pass through the digestive system ending in black, tarry stools. Other symptoms can involve shortness of breath or wheezing because the actual airway gets narrowed. There may be chest pain, sore throat, hoarseness, a feeling of a lump in the throat and sinus inflammation. In some cases an associated condition called reflux laryngitis may develop, with symptoms of larynx problems.

Long-lasting GERD can cause changes in the cells that line the esophagus at the juncture with the stomach. As the body tries to protect the esophagus from acids, some of the cells may change to resemble those in the stomach itself, which are protective against the acid. If this happens, the patient has Barrett's Esophagus, or Barrett's metaplasia. In a very small percent of these cases, estimated at 0.5 to 1.0 percent a year, Barrett's metaplasia progresses through stages from low grade dysplasia, to high grade dysplasia, and finally to a cancerous condition.

GERD can occur without any symptoms that are associated with acid indigestion, that is, a burning pain in the esophagus. With a weakened esophageal sphincter, the primary situation that allows stomach contents to back up, non-acidic stomach fluids can still reflux into the esophagus and cause symptoms described above. This often occurs when patients are taking drug therapy to control the production of acid by the stomach, or it may occur in the absence of such treatment. The drugs may reduce sharply the acid, but they do nothing to prevent other stomach substances from coming back up the esophagus and causing similar upper throat and mouth symptoms. Therefore, one cannot conclude that just because there is no acid indigestion that GERD is not present.