Acid-Related Diseases Backgrounder

Acid-Related Diseases
Acid-related diseases occur when stomach acids irritate and sometimes harm the linings of the esophagus, stomach or intestines. Such diseases include heartburn, gastroesophageal reflux disease (GERD), erosive esophagitis (EE), Helicobacter pylori infection.

Heartburn
Heartburn is a burning chest pain, sometimes severe, that radiates upward from behind the breastbone to the neck. It often is associated with the sensation of food coming back up into the mouth, often accompanied by a bitter (acid) taste. Sometimes it is not painful at all and is referred to as acid indigestion.¹ Heartburn usually is not associated with exercise, sweating or lightheadedness, which often accompany the chest pain signaling a heart attack. Any unexplained, lingering chest pain, however, warrants prompt medical attention to rule out problems with the heart.

Gastroesophageal Reflux Disease (GERD)
Gastroesophageal reflux disease (GERD) symptoms occur when the lower esophageal sphincter (LES) leaks. When the LES is weak or relaxes inappropriately, reflux occurs. This allows digestive fluids and stomach acid to back up from the stomach into the esophagus. This acid can irritate and sometimes damage the lining on the inside of the esophagus, leading to symptoms such as frequent heartburn or a bitter/acid taste in the mouth. The severity of GERD depends on LES dysfunction as well as the type and amount of fluid brought up from the stomach.

Erosive Esophagitis
Erosive esophagitis (breaks or erosions in the lining of the esophagus) is a more serious manifestation of GERD in which the gastric contents of the stomach pass upward and cause inflammation and tissue damage to the esophagus. Erosive esophagitis may be associated with complications including hemorrhage, stricture and Barrett’s esophagus, a condition associated with an increased risk of esophageal cancer.² In some patients, such damage can result in scarring and narrowing of the esophagus, making swallowing painful or difficult.

Helicobacter pylori
Helicobacter pylori (H. pylori) is a spiral shaped bacterium that is found in the gastric mucous layer or adherent to the epithelial lining of the stomach. H. pylori causes more than 90 percent of duodenal ulcers and more than 80 percent of gastric ulcers.³ Appropriate antibiotic regimens can successfully eradicate the infection in most patients, with complete resolution of mucosal inflammation and a minimal chance for recurrence of ulcers.

Approximately two thirds of the world's population is infected with H. pylori. In the United States, H. pylori is more prevalent among older adults, African Americans, Hispanics and lower socioeconomic groups.⁴ Most persons who are infected with H. pylori never suffer any symptoms related to the infection; however, H. pylori causes chronic active, chronic persistent and atrophic gastritis in adults and children. Infection with H. pylori also causes duodenal and gastric ulcers. The role of H. pylori in nonulcer dyspepsia remains unclear.