Barrett’s esophagus: The GERD and cancer connection

Cancer of the esophagus is considered relatively rare. However, its numbers have been increasing in recent years. Research published by the American Gastroenterological Association notes that rates of this cancer have close to doubled in adults under the age of 65.

One of the problems with detecting esophageal cancer is that its symptoms are minimal, so it’s often not discovered until it’s pretty far advanced. That’s why it’s important to become more familiar with the precursor to this type of cancer — a condition known as Barrett’s esophagus….

What is Barrett’s esophagus?

Barrett’s esophagus occurs when the cells lining your esophagus change to resemble the cells lining your intestines. This causes the cells to become damaged and can lead to cancer of the esophagus.

Barrett’s esophagus is more common in people with GERD, a more severe form of acid reflux, and in middle-aged or older non-Hispanic males. About 5 percent of the roughly 30 million North Americans with GERD will develop Barrett’s esophagus.

Other risk factors include obesity, a decade or more of heartburn symptoms or a family history of Barrett’s esophagus or esophageal cancer.

Experts believe the reason GERD raises the risk of Barrett’s esophagus is when the acidic liquid from the stomach flows backward into the esophagus, it irritates the lining and causes changes in the tissue. It’s important to note, however, that you can have Barrett’s esophagus without having GERD.

What are the symptoms?

One of the downsides of Barrett’s esophagus is there are no symptoms, so you often don’t even know you have it.

However, you can watch for heartburn symptoms, one of the conditions associated with Barrett’s esophagus. These include a burning sensation in the chest and acid regurgitation, which often feels like vomit in the back of the throat.

If you have heartburn that occurs at least twice a week, or that worsens or wakes you from sleep, those are signs you could be developing Barrett’s esophagus. It’s usually discovered after seeing your doctor for GERD symptoms or after developing esophageal cancer.

Other symptoms that could indicate Barrett’s esophagus include pain or difficulty swallowing, a sensation of food stuck in your esophagus, a constant sore throat, a sour taste in your mouth or bad breath. More serious symptoms include unintentional weight loss, blood in your stool or vomiting.

How can Barrett’s esophagus be treated?

Doctors can only diagnose Barrett’s esophagus through an upper endoscopy, a procedure that involves inserting a lighted tube with a camera into the throat to examine the tissue. The diagnosis is confirmed by conducting a tissue sample biopsy obtained through the endoscope.

Treatment depends largely on the presence of symptoms and whether the biopsy detects precancerous cells. If no precancerous cells are detected, no treatment is needed, but your doctor will likely want to monitor the condition by conducting an upper endoscopy every two to three years.

If the procedure does detect some precancerous cells, your doctor may recommend more frequent monitoring every six months or so. However, if there are substantial changes in the esophageal lining and numerous precancerous cells are detected, removal of the damaged tissue through surgery may be recommended.

Can Barrett’s esophagus be prevented?

The best way to prevent Barrett’s esophagus from developing is to treat heartburn or GERD symptoms right away. Untreated heartburn raises the risk of esophageal cancer by 64 times.

Your doctor may prescribe medications to decrease stomach acid, which can protect your esophagus from damage. However, these medications do have some side effects. Long-term use of one common class of drugs prescribed for acid reflux, proton pump inhibitors, has been linked with bone fractures, chronic kidney disease, gut infections, stomach cancer and diabetes, among other disorders.

Making lifestyle and dietary changes may help prevent acid reflux, GERD and heartburn.

“Diet plays a major role in controlling acid reflux symptoms and is the first line of therapy used for people with GERD,” says Ekta Gupta, M.B.B.S., M.D., gastroenterologist with Johns Hopkins Medicine.

They recommend limiting problem foods that can trigger heartburn or GERD symptoms, like fried or fatty foods, chocolate, carbonated drinks and tomato sauce. Instead eat high-fiber foods, including whole grains, root vegetables and green vegetables.

They also note that foods fall somewhere along the pH scale (an indicator of acid levels). Those that have a low pH are acidic and more likely to cause reflux. Those with higher pH are alkaline and can help offset strong stomach acid. Some alkaline foods are bananas, cauliflower, broccoli and nuts.

You should also maintain a healthy weight and avoid smoking and drinking alcohol, both of which can irritate the esophageal lining. Also, it’s helpful to eat dinner at least three hours before bedtime and sleep on a slight incline to prevent stomach acid from backing up into the esophagus.

If you already suffer from heartburn, acid reflux or GERD, there are some natural remedies you can explore in this article, including baking soda and apple cider vinegar.

Sources:

Barrett’s Esophagus — Cleveland Clinic

Barrett’s Esophagus — Johns Hopkins Medicine