Infant Acid Reflux Complications

Parents of infants or children with acid reflux are responsible for educating themselves on the possible results of the condition going untreated or even under treated. Our mission is to bring a portion of this knowledge to you, helping to bring comfort to your family. This page is not a full list of possible infant acid reflux complications or results, but it’s a great starting point.

Apnea – GERD commonly occurs with obstructive sleep apnea, a condition in which breathing stops temporarily but repeatedly during sleep. It is not clear which condition is responsible for the other, but GERD is particularly severe when both conditions occur together.

Asthma – Asthma and GERD often occur together. Studies report that reflux disorder coincides with between 32% and 80% of asthma cases. Some theories for the causal connection between GERD and asthma are as follows: Acid leaking from the lower esophagus in GERD stimulates the vagus nerves, which run through the gastrointestinal tract. These stimulated nerves in turn trigger the nearby airways in the lung to constrict, which causes asthma symptoms. Another theory: Acid back-up that reaches the mouth may be inhaled into the airways (aspirated). Here, the acid triggers a reaction in the airways that causes asthma symptoms.

Barrett’s Esophagus(BE) and Esophageal Cancer – In some cases, BE develops as an advanced stage of erosive esophagitis. Long-standing and/or severe GERD can cause change in the cells that line the esophagus. These cells are pre-cancerous and can become cancerous. This condition is referred to as Barrett’s esophagus and occurs in approximately 10% of patients with GERD. The type of esophageal cancer associated with Barrett’s esophagus (adenocarcinoma) is increasing in frequency. It is not clear why some patients with GERD develop Barrett’s esophagus, but most do not.

Erosive Esophagitis – Erosive esophagitis develops in chronic GERD patients when acid causes sufficient irritation and inflammation to the esophagus. In one study, bleeding occurred in over 8% of patients with erosive esophagitis. The liquid from the stomach that refluxes into the esophagus damages the cells lining the esophagus. The body responds in the way that it usually responds to damage, which is with inflammation (esophagitis). The purpose of inflammation is to neutralize the damaging agent and begin the process of healing. If the damage goes deeply into the esophagus, an ulcer forms. An ulcer is simply a break in the lining of the esophagus that occurs in an area of inflammation. Ulcers and the additional inflammation they provoke may erode into the esophageal blood vessels and give rise to bleeding into the esophagus. Occasionally, the bleeding is severe and may require transfusions of blood and endoscopic (a procedure in which a tube is inserted through the mouth into the esophagus) or surgical treatment.

Esophageal Ulcers – Open sores on the lining of the esophagus can result from repeated acid reflux. They cause pain that is usually located behind the breastbone or just below it, similar to the location of heartburn.

Other Respiratory and Airway Conditions – Current studies indicate an association between GERD and various upper respiratory problems that occur in the sinuses, ear and nasal passages, and airways of the lung. People with GERD appear to have an above-average risk for chronic bronchitis, chronic sinusitis, emphysema, pulmonary fibrosis (lung scarring), and recurrent pneumonia. If a person inhales fluid from the esophagus (aspirates) into the lungs, serious pneumonia can occur.

Strictures – Ulcers of the esophagus heal with the formation of scars (fibrosis). Over time, the scar tissue shrinks and narrows the lumen (inner cavity) of the esophagus. This scarred narrowing is called a stricture. Swallowed food may get stuck in the esophagus once the narrowing becomes severe enough (usually when it restricts the esophageal lumen to a diameter of one centimeter). This situation may necessitate endoscopic removal of the stuck food. Then, to prevent food from sticking, the narrowing must be stretched (widened). Moreover, to prevent a recurrence of the stricture, reflux also must be prevented.

Throat Conditions – An estimated 20% to 60% of patients with GERD have atypical symptoms in the throat (hoarseness, sore throat) without any significant heartburn. A failure to diagnose and treat GERD may lead to persistent throat conditions such as chronic laryngitis, hoarseness, difficulty in speaking, sore throat, cough, constant throat clearing, and granulomas (soft, pink bumps) on the vocal cords. Hypertrophic (overgrown) tonsils and/or adenoids due to repeated exposure to stomach acid.

To be added soon:

Sandifer Syndrome
FTT (Failure to Thrive)
ALTEs (Apparent Life Threatening Events)
Esophageal Motility Disorder

Sources:
THCN 2006, “Acid Reflux Complication” (online)
www.healthcentral.com/acid-reflux/introduction-000085-145.html
Marks, J. 2010, “Gastroesophageal Reflux Disease”, Medicine Net (online) available at www.medicinenet.com