Complications of Gastroesophageal Reflux (GERD) • Asthma – gastric acid regurgitates from stomach and irritates the nerve endings of esophagus to which brain responds by sending signals to lungs which in turn produces mucus in airways and constrict the airway muscles • Barrett’s esophagus – repeated exposure of lower esophagus with gastric acid initiates metaplasia of stratified squamous epithelium into simple columnar epithelium • Esophagitis – regurgitation of gastric acid into the esophagus due to weak valve function often causes inflammation of esophagus • Ulceration and bleeding - exposure of lower esophagus with gastric acid results in the wearing away of protective layer causing bleeding • Sinusitis – more commonly in children, the gastric acid from stomach regurgitates into nose and sinuses causing inflammation • Regurgitation of gastric acid into lungs – aspiration of gastric acid into lungs produces aspiration pneumonitis and aspiration pneumonia • Esophageal stricture – Repeated inflammation of esophageal lining with gastric acid ultimately results in scarring and strictures • Tooth decay – Gastric acid decays the enamel on backside of teeth especially molars