Gastroesophageal Reflux Disease (GERD): Complications
Esophageal stricture
disease
Esophagitis
Esophageal
adenocarcinoma
Barrett’s esophagus
GERD
Reflux of gastric content into distal esophagus
Damage to squamous
esophageal epithelium
Legend: Published March 30, 2019 on www.Pathophysiology Mechanism Sign/Symptom/Lab Finding Complications thecalgaryguide.com
Authors:
Wendy Wang
Reviewers:
Yoyo Chan
Sean Doherty
Dr. Sylvain Coderre*
* MD at time of publication
Squamous esophageal
epithelium undergoes
metaplasia to become
columnar epithelium
This predisposes cells to
premalignant changes
(dysplasia)
Collagen is deposited
where ulcers heal
Asthma/Chronic Cough
Chronic Laryngitis
Laryngeal and
Tracheal Stenosis
Extra-esophageal Complications Esophageal Complications
Airway becomes
irritated
Fibroblasts proliferate
and deposit granulation
tissue in airway
Tissue deposition
leads to narrowing of
laryngeal and
tracheal space
Damage to pharyngeal
lining and airway
Esophageal tissue repeatedly
exposed to stomach acid
Pro-inflammatory cells and cytokines
are recruited to the area
Definitions:
• Metaplasia: abnormal change in the
nature of a tissue
• Pro-inflammatory cells and cytokines:
Mediators of inflammation. Examples
of cells include macrophages and T
cells, cytokines include IL-17, IL-2, IL-4
Over time, collagen fibers
contract
Bronchoconstriction
↑ vagal
tone
↑ bronchial
reactivity
Cough sensory
nerve endings are
stimulated
Vagal reflex
is activated
Activation of
cough center in
brainstem
↑ inflammation of
squamous epithelium
Ulcers form in esophagus