Gastroesophageal Reflux Disease (GERD) is a common digestive condition involving the frequent backflow of stomach contents, including stomach acid, into the esophagus. This recurring reflux can lead to various symptoms and complications.
GERD and Ulcers Explained
GERD is a chronic condition characterized by stomach acid persistently flowing back into the esophagus. This occurs when the lower esophageal sphincter, a muscle that acts as a valve between the esophagus and stomach, does not close properly. Common indicators of GERD include heartburn, a burning sensation in the chest, and the regurgitation of sour liquid or food.
Ulcers are open sores that develop on the protective lining of the digestive tract. These sores form when digestive juices erode the mucosal barrier. While ulcers can occur in various parts of the digestive system, those most relevant to GERD are esophageal ulcers, gastric ulcers (in the stomach), and duodenal ulcers (in the first part of the small intestine). Esophageal ulcers are directly linked to acid reflux, whereas gastric and duodenal ulcers typically arise from other primary causes, such as bacterial infection or certain medication use.
How GERD Can Lead to Ulcer Formation
Chronic exposure to stomach acid due to GERD can directly lead to esophageal ulcers. The lining of the esophagus is not designed to withstand the corrosive effects of stomach acid and digestive enzymes. When these acidic contents repeatedly reflux into the esophagus, they irritate and wear away its delicate tissue. This prolonged irritation results in inflammation, known as esophagitis, which can progress to the development of open sores or breaks in the esophageal lining. These esophageal ulcers are a direct complication of long-standing GERD.
While GERD is a direct cause of esophageal ulcers, it typically does not directly cause gastric or duodenal ulcers. The primary causes of ulcers in the stomach and small intestine are often an infection with Helicobacter pylori bacteria or the long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs). However, severe acid reflux can act as a contributing risk factor or exacerbate existing gastric or duodenal ulcers.
Symptoms indicating the presence of an ulcer can vary depending on its location. Esophageal ulcers commonly cause pain when swallowing, difficulty swallowing, or a burning pain behind the breastbone. Gastric and duodenal ulcers often present with a dull or burning pain in the upper abdomen, which may be worse when the stomach is empty or at night. In some instances, ulcers can lead to more serious signs, such as vomiting blood, dark or tarry stools, or persistent nausea and vomiting, requiring prompt medical evaluation.