A number of possible complications can occur as a result of having long-term gastro-oesophageal reflux disease (GORD).

Oesophageal ulcers

The excess acid produced by GORD can damage the lining of your oesophagus (oesophagitis), which can 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.

Medications used to treat GORD can take several weeks to become effective, so it's likely your GP will recommend 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 medications and are available from pharmacies. The pharmacist will advise you about the types of antacid and alginate that 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 can include:

• diarrhoea 
• vomiting 
• flatulence 

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, your oesophagus can become narrowed. This is known as oesophageal stricture.

An oesophageal stricture can make swallowing food painful (odynophagia) and difficult (dysphagia). Oesophageal strictures can be treated using a tiny balloon or other type of dilator, such as a bougie, to widen (dilate) the oesophagus.

This procedure is usually carried out under a local anaesthetic at the same time as an endoscopy, which is an internal examination using an endoscope.

Barrett’s oesophagus

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

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

Barrett’s oesophagus doesn't usually cause noticeable symptoms other than those associated with GORD.

However, Barrett’s oesophagus is a pre-cancerous condition. This means that changes in the cells aren't cancerous, but there's a small risk they could become cancerous in the future. This would then trigger the onset of oesophageal cancer (see below).

Oesophageal cancer

Each year in England, it's estimated that 1 in every 200 people with Barrett’s oesophagus develop oesophageal cancer.

Risk factors that increase the risk of 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's thought you have an increased risk of developing oesophageal cancer, it's likely you'll be referred for a regular endoscopy, to monitor the affected cells.

If oesophageal cancer is diagnosed in its initial stages, it can usually be treated and cured, first by carrying out an endoscopic resection, followed by radiofrequency ablation (RFA).

An endoscopic resection is where abnormal areas of the oesophagus lining are removed for further examination using special instruments during an endoscopy.

RFA can then be carried out, where controlled pulses of energy are used to remove the thin surface layer of tissue that contains the affected cells. It's usually carried out while the patient is conscious, but sedated.

Read more about treating oesophageal cancer.