Acid Reflux, GERD and Barrett's Esophagus
Increasing the Risk of Cancer of the Esophagus
Oct 26, 2009
Food and drink, once swallowed, travels from the mouth to the stomach through a muscular tube in the chest called the esophagus. A muscular ring at the base of the esophagus, called a sphincter, opens to allow the food into the stomach, and then closes to create a seal to prevent stomach contents from backing up into the esophagus. Acid reflux occurs when the sphincter muscle, for various reasons, relaxes or malfunctions, and allows stomach acids into the esophagus.
Acid Reflux Symptoms
The main symptom of acid reflux is pain similar to a burning sensation in the chest. Other symptoms are hiccups, coughing, and in severe cases, stomach acid that backs up into the throat or mouth.
Most people experience acid reflux from time to time, perhaps after a large or rich meal. When acid reflux occurs regularly or frequently, such as more than twice a week, it is considered a disease.
Gastroesophageal Reflux Disease (GERD)
Gastroesophageal reflux disease, or GERD, can occur when the sphincter muscles at the base of the esophagus are weak or malfunction such that stomach contents regularly back up into the esophagus. The symptoms of GERD are, of course, similar to those of acid reflux, but are more persistent and lower the quality of life for sufferers. Treatments for GERD range from over-the-counter remedies such as Alka-Seltzer and Pepto-Bismol, prescribed medications such as Nexium and Prilosec, to surgical procedures to strengthen or replace the action of the sphincter muscles.
Barrett's Esophagus
Frequent episodes of stomach acid bathing the lining of the esophagus can cause cellular changes in that lining over time. The lining tissue is of a type known as squamous, or scale-like, tissue. The tissue changes that occur result in cells that are more columnar, normally found in glandular organs in the body.
These changes are asymptomatic; that is, they do not produce any noticeable symptoms. The only way doctors can diagnose Barrett's esophagus is to pass an endoscope - a probe with a camera and light on the end - through the esophagus to examine and take a sample of the cells of the esophageal lining for biopsy.
It is important to note that the mechanism of cellular change is still not well understood. Barrett's esophagus can occur in people who do not suffer from GERD, and GERD does not definitively lead to Barrett's esophagus.
Why is Barrett's Esophagus Important?
The tissue changes that lead to a diagnosis of Barrett's esophagus create an increased risk of adenocarcinoma, or cancer, of the esophagus. The risk is very low - typically around one per cent of patients with Barrett's esophagus will go on to develop cancer of the esophagus. However, as esophageal cancer is a disease with low survival statistics, many doctors recommend regular endoscopic examinations once Barrett's esophagus is diagnosed. Indeed, some even recommend regular examinations for sufferers of long-term GERD.
Treatments for Barrett's Esophagus
Barret's esophagus that shows indications of cellular change towards development of cancer is usually treated with surgical techniques. These may involve removal of the affected section of the esophagus and reconnecting the stomach to the remaining esophagus (see also Recovery from Esophageal Cancer Surgery) or endoscopic techniques to remove just the affected cells.
Important Note
The author is not a medical professional and is writing from both experience of open surgery and research carried out before and after surgery.
Related Articles
Fighting Esophageal Cancer:Prognosis and Treatment of Cancer of the Esophagus
Sources:
National Digestive Diseases Information Clearinghouse
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