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Complications
By Mayo Clinic staffSticky mucous coats and protects the lining of your stomach from the corrosive effects of stomach acid. The esophagus lacks this protection, so acid and bile reflux can seriously damage esophageal tissue. The combination of bile and acid reflux increases the risk of complications, including:
- GERD. Occasional heartburn usually isn't a concern. But frequent or continual heartburn is the most common symptom of GERD, a potentially serious problem that causes irritation and inflammation of esophageal tissue (esophagitis). GERD is most often due to excess acid. Although bile has been implicated, its importance in reflux is controversial.
- Barrett's esophagus. This serious condition can occur when long-term exposure to stomach acid, or to acid and bile, damages tissue in the lower esophagus. The damaged esophageal cells (metaplasia) have an increased risk of becoming cancerous. Animal studies have also linked bile reflux to the occurrence of Barrett's esophagus.
- Esophageal cancer. This serious form of cancer may not be diagnosed until it's quite advanced. The possible link between bile and acid reflux and esophageal cancer remains controversial, but many experts think a direct connection exists. In animal studies, bile reflux alone has been shown to cause cancer of the esophagus.
References
- Mercer DW, Townsend CM, et al. Sabiston Textbook of Surgery: The Biological Basis of Modern Surgical Practice. 18th ed. Philadelphia, Pa.: Saunders Elsevier; 2008. http://www.mdconsult.com/das/book/body/169271004-2/0/1565/453.html?tocnode=54738708&fromURL=453.html. Accessed Jan. 2, 2012.
- Feldman M, et al. Sleisenger & Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. 9th ed. Philadelphia, Pa.: Saunders Elsevier; 2010. http://www.mdconsult.com/das/book/body/165017723-5/902729765/1389/357.html#4-u1.0-B1-4160-0245-6..50054-8--cesec51_2169. Accessed Jan. 2, 2012.
- Heartburn, gastroesophageal reflux (GER), and gastroesophageal reflux disease (GERD). National Digestive Diseases Information Clearinghouse. http://digestive.niddk.nih.gov/ddiseases/pubs/gerd/. Accessed Dec. 31, 2011.
- Kiefer D. Gastroesophageal reflux disease. In: Rakel RE. Integrative Medicine. Philadelphia, Pa.: Saunders Elsevier; 2007. http://www.mdconsult.com/das/book/body/165168078-5/903199144/1494/89.html#4-u1.0-B978-1-4160-2954-0..50046-6_2173. Accessed Jan. 2, 2012.
- Wang DH, et al. Aberrant epithelial-mesenchymal hedgehog signaling characterizes Barrett's metaplasia. Gastroenterology. 2010;138:1810.
- Richter JE. Role of the gastric refluxate in gastroesophageal reflux disease: acid, weak acid and bile. American Journal of the Medical Sciences. 2009;338:89.
- Yamada T, et al. Bile-acid-induced calcium signaling in mouse esophageal epithelial cells. Biochemical and Biophysical Research Communications. 2011;414:789.
- Cheng P, et al. Effects of refluxate pH values on duodenogastroesophageal reflux-induced esophageal adenocarcinoma. World Journal of Gastroenterology. 2011;17:3060.
- Picco MF (expert opinion). Mayo Clinic, Rochester, Minn. Jan. 15, 2012.
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