Oesophageal ulcers

The excessive acid that is produced by gastro-oesophageal reflux disease (GORD) can damage the lining of your oesophagus and eventually lead to the formation of ulcers. The ulcers can bleed, causing pain and making swallowing difficult. Ulcers can usually be successfully treated by controlling the underlying symptoms of GORD.

The medications that are used to treat GORD can take several weeks to become effective, so it is likely that your GP will recommend some additional medication to provide short-term relief from your symptoms.

Two types of medication that can be used are:

• antacids to neutralise stomach acid on a short-term basis
• alginates, which produce a protective coating on the lining of your oesophagus

Both antacids and alginates are over-the-counter (OTC) medications that are available from pharmacists. The pharmacist will be able to advise you about which particular types of antacid and alginate are most suitable for you.

Antacids are best taken when you have symptoms, or when symptoms are expected, such as after meals or at bedtime. Alginates are best taken after meals.

Side effects for both medications are uncommon but include:

• diarrhoea
• vomiting
• flatulence (wind)

Oesophageal stricture

Repeated damage to the lining of your oesophagus can lead to the formation of scar tissue. If the scar tissue is allowed to build up, it can cause your oesophagus to become narrowed. This is known as oesophageal stricture.

An oesophageal stricture can make swallowing food difficult and painful. Oesophageal strictures can be treated by using a tiny balloon to widen (dilate) the oesophagus. This procedure is usually carried out under a local anaesthetic.

Barrett’s oesophagus

Repeated episodes of GORD can lead to changes in the cells of the lining of your lower oesophagus. This is a condition known as Barrett’s oesophagus.

It is estimated that 1 in 10 people with GORD will develop Barrett’s oesophagus. Most cases of Barrett’s oesophagus first develop in people who are between 50 and 70 years old. The average age at diagnosis is 62.

Barrett’s oesophagus does not usually cause any noticeable symptoms other than those that are associated with GORD. However, there is a small risk that the cells that are affected by Barrett’s oesophagus could turn cancerous and trigger the onset of oesophageal cancer.

Oesophageal cancer

Each year in England it is estimated that 1 in every 200 people with Barrett’s oesophagus develop oesophageal cancer. Risk factors that increase the risk of the cells in the lining of your oesophagus turning cancerous include:

• being male
• having the symptoms of GORD for longer than 10 years
• having three or more episodes of heartburn and related symptoms a week
• smoking
• obesity

If it is thought that you have an increased risk of developing oesophageal cancer, it is likely that you will be referred for regular endoscopies in order to monitor the condition of the affected cells.

If oesophageal cancer is diagnosed in its initial stages, it is usually possible to cure the cancer using a type of treatment called photodynamic therapy (PDT).

PDT involves injecting your oesophagus with a special type of medication that makes it very sensitive to the effects of light. A laser that is attached to an endoscope is placed inside your oesophagus and burns away the cancerous cells.

See the Health A-Z topic about Cancer of the oesophagus for more information.