Development of Gastro-Oesophageal Reflux Disease

The main complications are oesophagitis, (gastrointestinal) bleeding, stricture and Barrett's oesophagus (which has a risk of progressing to oesophageal cancer).

• Reflux oesophagitis is the most common complication, when stomach acid leaks into the oesophagus, inflaming it and damaging tissue.
• Oesophageal stricture appears in untreated cases of oesophagitis. The continuous injury to the mucosa ends up scarring and this can narrow the internal diameter of the oesophagus. It appears as difficulty swallowing (dysphagia). Gastroscopy with biopsies have to be performed to confirm the benign nature of the stricture, and sometimes the affected region must be dilated.
• Barrett's oesophagus (BO) is a disorder in which oesophagus mucosa is replaced by stomach mucosa. An endoscopy is required to diagnose it. Patients with BO and other risk factors are included in an oesophageal adenocarcinoma screening programme. Risk factors are: being male, having frequent symptoms or symptoms lasting more than 5 years, being over 50 years old, Caucasian, smoking, obese and having a first-degree family history of BO or oesophageal cancer.