Gastroesophageal reflux disease (GERD) is a chronic condition that involves a backflow of stomach contents into the esophagus, the tube that carries food and fluids from the mouth to the stomach. This backflow can happen when the valve (sphincter muscle) that separates the esophagus from the stomach does not function properly, or when pressure within the stomach is greater than that exerted by the sphincter.
GERD often occurs in people who have a hiatal hernia, a condition that allows a part of the stomach, including the valve, to move into the chest. Over the course of months and years, exposure to stomach acids and bile can cause inflammation, ulceration, and changes in the lining of the lower part of the esophagus. These are hallmarks of a condition called Barrett’s esophagus.
In some people with Barrett’s esophagus, the cells may undergo further precancerous changes (dysplasia) that may lead to a common form of esophageal cancer called adenocarcinoma.
The stages of Barrett’s esophagus are:
- non-dysplastic (no cancerous tissue present)
- low-grade dysplasia (minor cell changes found)
- high-grade dysplasia (extensive cell changes found)
- invasive cancer
Another chronic condition that can increase the risk for developing esophageal cancer is achalasia, a rare illness in which the nerves that signal swallowing become damaged and allow food to get stuck in the esophagus.
Chronic backflow of stomach contents into the esophagus due to GERD can cause heartburn, a burning feeling in the throat or chest. For many people this sensation occurs 30 to 60 minutes after eating, and becomes more severe during exercise or when lying down. It can also lead to sudden fits of coughing at night during sleep. Other symptoms include regurgitation and “water brash,” a sour taste in the mouth that usually occurs after waking up.
Some people with GERD or Barrett’s esophagus have only a sore throat, chronic cough, or hoarseness. Others experience no symptoms at all.
People with achalasia may experience refluxlike symptoms such as heartburn, regurgitation, and pain with swallowing.