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Are You Still Ignoring Your Heartburn? You Might Regret It

heartburn

Heartburn, or acid reflux, can produce discomfort or burning pain in the chest or stomach. A brief episode following a large meal is not unusual and typically does not lead to complications or chronic symptoms.

Occasionally, heartburn occurs more regularly and results in frequent or bothersome symptoms. This condition is called gastroesophageal reflux disease, or GERD.

Over time, GERD can damage the esophagus and is a risk factor for esophageal cancer.

What Causes Heartburn?

The esophagus is a tube-like structure that carries food from the mouth to the stomach. It is made up of muscle layers that produce a series of wave-like movements, propelling food to the stomach.

There is a ring of muscle called the lower esophageal sphincter (LES) where the lower end of the esophagus connects to the stomach. Swallowing causes the LES to relax and open, allowing food to pass. Once the food has entered the stomach for digestion, the LES closes shut, preventing food and stomach acid from backing up into the esophagus.
If the LES remains relaxed, acid from the stomach can wash back into the esophagus causing a burning sensation in the middle of the chest or back of the throat. This is known as heartburn.

What is GERD?

For some, bothersome symptoms or injury to the esophagus can occur when stomach acid refluxes frequently over a period of time. This condition is known as GERD. Some factors that increase the risk for developing GERD are:

  • Hiatal hernia
  • Obesity
  • Pregnancy
  • Fatty foods
  • Caffeine
  • Alcohol
  • Cigarette smoking

Heartburn is the most common symptom of GERD. Sometimes people experience regurgitation which is when stomach acid and food flow back into the mouth or throat. Other symptoms of GERD may include:

  • Belching
  • Stomach pain or pain in the upper abdomen
  • Chest pain
  • Difficulty with, or pain in swallowing
  • Laryngitis or hoarseness
  • Sore throat or persistent cough
  • Nausea, with or without vomiting

Most people with GERD will not develop serious complications, especially if they get treatment.

However, without proper care, chronic GERD can lead to potentially serious complications related to esophageal damage, such as:

  • Erosive esophagitis — The esophageal lining is damaged resulting in erosions or ulcers which may bleed.
  • Esophageal stricture — The esophagus scars and causes a partial blockage or narrowing.
  • Barrett’s esophagus — The normal cells that line the lower esophagus, called squamous cells, are replaced by intestinal cells during the healing phase of esophagitis.

The Link Between Chronic GERD and Cancer

Repeated damage to the esophageal lining and persistent GERD is the most common cause of Barrett’s esophagus. Some factors that increase the risk of developing Barrett’s esophagus include:

  • Age over 45
  • Male
  • Central obesity, where fat accumulates mostly in the abdomen
  • A history of smoking
  • A family history of Barrett’s esophagus or adenocarcinoma of the esophagus

One possible complication of Barrett’s esophagus is that the damaged cells of the esophageal lining have a risk of becoming precancerous.

If left undetected, these changes may progress to esophageal cancer. It is important for those who have longstanding GERD to see a doctor and get checked for Barrett’s esophagus.

How to Reduce the Risk of Developing Barrett’s Esophagus

Certain lifestyle choices may help to address the frequency and severity of GERD symptoms and reduce the risk of developing Barrett’s esophagus. These lifestyle choices include:

  • Losing weight
  • Avoiding late or large meals
  • Limiting or avoiding foods that worsen symptoms
  • Elevating the head of the bed six to eight inches
  • Wearing loose, comfortable clothing
  • Quitting smoking

In addition to lifestyle changes, the use of nonprescription or prescription medications may be advised, such as:

  • Antacids or alginates to neutralize stomach acid – like Tums or Maalox
  • Histamine receptor antagonists which reduce the production of acid in the stomach – like Pepcid or Zantac
  • Proton pump inhibitors (PPIs) which cause a significant and long-lasting reduction of stomach acid production – like Prilosec and Nexium

How to Prevent Esophageal Cancer

People with Barrett’s esophagus are advised to have a periodic upper endoscopy to monitor for early warning signs of cancer. An upper endoscopy is a medical procedure performed by a gastroenterologist.

Using a tiny camera attached to a long flexible tube, a gastroenterologist visually inspects the upper digestive system. The doctor may also remove tissue from the esophagus and examine it to determine the degree of damage or change.

Don’t ignore your symptoms of heartburn and risk developing complications – schedule an appointment today!

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