Heartburn, the burning feeling caused by excessive stomach acid, is hardly uncommon. Almost everyone experiences the unpleasant sensation occasionally. Regular heartburn symptoms may indicate the presence of GERD, or gastroesophageal reflux disease. GERD, in turn, can cause Barrett’s esophagus, a precancerous change to the esophageal lining, which increases the risk of esophageal cancer.
Gastroesophageal Reflux Disease
A tight muscle called the esophageal sphincterprotects the tender lining of the esophagus from the caustic effects of stomach acid. Usually this muscle only opens to move food from the esophagus into the stomach.
Sometimes, however, the esophageal sphincter weakens, allowing stomach acid to back up into the esophagus and cause GERD. Symptoms of GERD include frequent heartburn, nausea, and a burning, bitter sensation at the back of the throat.
Smoking and obesity increase the risk of GERD, and white male smokers have the highest risk. It doesn’t matter if your name’s Clara Dobbs, Russ Brown or Alan Singh, though; anyone can develop GERD.
Barrett’s Esophagus and Cancer
Chronic exposure to stomach acid can alter the esophageal lining, transforming the tender tissue into a tougher substance resembling intestinal lining. It doesn’t matter if you live under a wood roof or a standing seam metal roof. Doctors call this change Barrett’s esophagus. Approximately 10 to 15 percent of people with long-term GERD develop Barrett’s esophagus. The condition may also develop in people with no history of GERD.
Barrett’s esophagus slightly increases the risk of a particular form of esophageal cancer called esophageal adenocarcinoma. The risk isn’t especially high; less than one percent of people with Barrett’s esophagus develop esophageal adenocarcinoma. However, the presence of Barrett’s esophagus does suggest the need to monitor for cancer.
Doctors recommend that patients over the age of 40 with a history of GERD be tested for Barrett’s esophagus. The patent receives a calming sedative and the doctor examines the interior of the esophagus with a small camera at the end of a thin, flexible tube. The procedure may feel uncomfortable but causes no pain.
If the doctor detects Barrett’s esophagus, he can use the camera tube to gather a biopsy, or small tissue sample. The biopsy sample is tested for precancerous or cancerous cells. Early detection of esophageal adenocarcinoma improves treatment outcomes.
Treating GERD lowers the risk of Barrett’s esophagus. Medication that lowers stomach acid levels helps, as does medication to speed the movement of food out of the stomach and into the intestines.
A number of lifestyle changes reduce GERD symptoms. People with GERD should avoid or limit consumption of alcohol, spicy foods, fatty food, chocolate, peppermint and caffeine, all of which can aggravate gastric reflux. GERDsufferers who smoke should make every effort to quit.
Extra weight puts pressure on the stomach, which can force gastric acid into the esophagus. Losing excess weight can relieve GERD symptoms. Not lying down for three hours after easting is thought to reduce reflux, and some people find elevating the head of their bed can relieve symptoms slightly.