GERD can be accompanied by complications or cause special situations, including:

• Asthma
• Barrett’s Esophagus
• Hiatal Hernia
• GERD in Infants and Children

Asthma is a disease of the respiratory system. Asthma occurs when the airways narrow. This narrowing causes symptoms such as wheezing, coughing, shortness of breath, and tightness in the chest.

Some people with GERD do not suffer from heartburn, a common symptom of GERD. Instead, they suffer from coughing, wheezing, hoarseness, or sore throat. These are all symptoms of asthma, a serious medical condition. In fact, asthma is common in patients with GERD and the two conditions are thought to be related:

• Patients with GERD are more likely to suffer from asthma.²
• There are several ways that GERD can cause asthma attacks or “bronchospasms”. ²
• Aggressive GERD treatment often results in improvement in asthma symptoms.²

Barrett’s esophagus is a serious condition that may occur in people who suffer from GERD. In GERD, stomach acid is able to reflux from the stomach to the esophagus because the lower esophageal sphincter is faulty. Barrett’s esophagus refers to damage to the lining of the esophagus because of long-time exposure to stomach acid.

In Barrett’s esophagus, long-time exposure to stomach acid can cause changes to the cells that line the esophagus. The normal cells that line the esophagus turn into tall, narrow cells that are similar to cells lining either the stomach or the intestine.

Barrett’s esophagus significantly increases the risk of esophageal cancer.³ Barrett’s esophagus is a precancerous condition. The frequency of esophageal cancer is growing more quickly than that of any other cancer in the U.S. and the five-year survival rate of this cancer is very low.⁴ Therefore, it is very important to monitor patients diagnosed with Barrett’s esophagus.

Symptoms of Barrett’s esophagus are the same as GERD, but often more severe. Some people, however, do not have symptoms at all.

A hernia occurs when an internal body part goes into an area where it doesn’t belong. The hiatus is an opening in the diaphragm, the muscular wall separating the chest cavity from the abdomen.

Normally, the esophagus goes through the hiatus and attaches to the stomach. In a hiatal hernia, the stomach bulges or protrudes into the chest through that opening. People suffering from GERD often have a hiatal hernia. However, many people have hiatal hernias without GERD.

Hiatal hernias can be serious medical conditions. In some cases of hiatal hernia, the stomach squeezes through the hiatus and then is squeezed by the hiatus. At that point, surgery may be recommended. If the hiatal hernia is constricted and the blood supply is cut off, surgery may be necessary.

It may surprise you to learn that infants and children can have GERD.

So, what are the symptoms of GERD in infants and children? Common symptoms include:

• Frequent vomiting
• Persistent coughing
• Refusing to eat or difficulty eating
• Crying while being fed
• Heartburn, gas, abdominal pain

Many babies outgrow GERD by the time they are 1 year old. Often, infants suffer from GERD because of their immature digestive system.

In older children, the causes of GERD are similar to the causes of GERD in adults: The lower esophageal sphincter relaxes and allows stomach acid to irritate the esophagus. Certain factors can cause GERD:

• Obesity
• Overeating
• Certain foods, beverages, or medications

Physicians may be more likely to recommend a minimally invasive procedure to treat GERD in children. Children with GERD will have to be more careful with regard to what they eat and the position in which they sleep, and, in some severe cases, may have to take medication every day for the rest of their lives.⁹