Occasional heartburn typically starts with a big meal or after eating spicy foods or drinking too many carbonated beverages. But if it happens frequently and is accompanied by a bitter taste of acid in the back of the mouth, it may be a sign of gastroesophageal reflux disease (GERD). GERD causes discomfort but can usually be controlled with medications once diagnosed. However, a long-term battle with GERD can lead to more serious complications of the esophagus.
“Everyone has a little bit of acid reflux that comes into the esophagus from time to time. When there’s enough reflux over a long period of time, that chronic acid exposure can actually damage the lining of the esophagus,” explains Dean Ehrlich, MD, a gastroenterologist on the Baylor Scott & White Medical Center – Plano medical staff.
Over time, this damage could lead to three common complications: esophagitis (inflammation within the esophagus), stricturing (narrowing or blockage of the esophagus), or Barrett’s esophagus.
What’s Barrett’s esophagus?
“In simple terms, Barrett’s esophagus is a condition in which the normal lining of the lower esophagus is replaced by a different type of cell,” says Dr. Ehrlich. “This occurs as a protective response to chronic acid exposure.”
While this change in cell type may not cause any immediate symptoms, it does significantly increase the risk of esophageal cancer.
Dr. Ehrlich is careful to point out that although Barrett’s significantly increases the lifetime risk of developing esophageal cancer, the overall risk of getting this form of cancer is still low, even for those with the condition. “It’s still quite unlikely that you will get cancer if you have Barrett’s,” he says. “But because we know that Barrett’s can progress toward cancer, we can monitor it and intervene before it gets there.”
Uncover, then control
One of the primary risk factors for developing Barrett’s esophagus is having GERD for five years or more. But there are other risk factors:
• History of smoking or tobacco use
• Obesity
• Caucasian males
• Over age 50
• Family history of esophageal cancer or Barrett’s esophagus
Unlike colon cancer or breast cancer, which have clear, established screening guidelines, who exactly should be tested for Barrett’s esophagus is not as clearly defined by various medical societies. However, Dr. Ehrlich says people with any combination of these risk factors — and especially those with longstanding GERD — should have a conversation with their doctor about getting screened. This is especially true for those experiencing difficulty swallowing, unintentional weight loss, or GERD symptoms that are difficult to control with routine medications.
“Upper endoscopy is the standard method used to diagnose Barrett’s esophagus,” says Dr. Ehrlich. “This involves threading a thin, flexible tube with a camera and light through the mouth down into the esophagus while the patient is sedated. “It allows us to visually see this change in the cell lining and then take tissue samples to confirm whether Barrett’s is present.”
If detected, patients may be placed on medication to help prevent progression and then undergo follow-up endoscopy every three to five years. If the tissue samples taken during the procedure indicate dysplasia (cells that are closer to cancer), nonsurgical endoscopic procedures can be performed to eliminate those cells to greatly reduce the risk of cancer.
“Barrett’s can be a serious condition if left uncontrolled and unmonitored,” says Dr. Ehrlich, “but it’s quite manageable once it’s diagnosed and treated by a gastroenterologist.”
Heartburn concerning you? Find a specialist.
Get checked out today at Baylor Scott & White – Plano’s gastroenterology team. Visit bswhealth.comy and put your mind at ease.
Baylor Scott & White Medical Center – Plano Gastroenterology
