Occasional heartburn often occurs after a large meal or following spicy foods or excessive carbonated beverages. But when heartburn becomes frequent and is accompanied by a bitter, acidic taste in the back of the mouth, it may signal gastroesophageal reflux disease, or GERD.
GERD can be uncomfortable but is often manageable with medication once diagnosed. However, over time, long-standing GERD can lead to more serious complications affecting 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,” said Dr. Dean Ehrlich, a gastroenterologist on the Baylor Scott & White Medical Center – Plano medical staff.
With prolonged exposure, this damage can result in three common complications: esophagitis (inflammation of the esophagus), stricturing (narrowing or blockage of the esophagus) or Barrett’s esophagus.
Understanding 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,” Ehrlich said. “This occurs as a protective response to chronic acid exposure.”
Although this change in cell type may not cause immediate symptoms, it does significantly increase the risk of esophageal cancer.
Ehrlich emphasized that, while Barrett’s esophagus increases the lifetime risk of developing esophageal cancer, the overall risk remains relatively low even for those diagnosed with the condition.
“It’s still quite unlikely that you will get cancer if you have Barrett’s,” he said. “Because we know that Barrett’s can progress toward cancer, we can monitor it and intervene before it gets there.”
Identify risk, then manage it
One of the primary risk factors for developing Barrett’s esophagus is having GERD for five years or longer. Additional risk factors include:
- History of smoking or tobacco use
- Obesity
- Being a Caucasian male
- Being over age 50
- Family history of esophageal cancer or Barrett’s esophagus
Unlike colon or breast cancer, which have well-established screening guidelines, recommendations for Barrett’s esophagus screenings are less clearly defined among medical societies.
Ehrlich noted that individuals with a combination of these risk factors—particularly those with long-standing GERD—should discuss screening with their doctor. This is especially important for people who experience difficulty swallowing, unintended weight loss or GERD symptoms that are hard to control with standard medications.
“Upper endoscopy is the standard method used to diagnose Barrett’s esophagus,” Ehrlich said.
This procedure involves passing a thin, flexible tube equipped with a camera and light through the mouth and 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,” Ehrlich said.
If Barrett’s esophagus is diagnosed, patients may be prescribed medication to help prevent progression, and typically undergo follow-up endoscopy every three to five years. When tissue samples show dysplasia (cells that are closer to cancer), nonsurgical endoscopic treatments can be used to remove those cells and significantly reduce cancer risk.
“Barrett’s can be a serious condition if left uncontrolled and unmonitored,” Ehrlich said. “But it’s quite manageable once it’s diagnosed and treated by a gastroenterologist.”
Take control of your GI health
Looking to improve your digestive health? Download the MyBSWHealth app for activities that support colon and overall health, or to find a gastroenterologist or primary care physician who can help put your gut at ease.
Physicians provide clinical services as members of the medical staff at one of Baylor Scott & White Health’s subsidiary, community or affiliated medical centers and do not provide clinical services as employees or agents of Baylor Scott & White Health or those medical centers.
The above story was produced by the Baylor Scott & White Medical Center – Plano team with Community Impact's Storytelling team, using information solely provided by the local business as part of their "sponsored content" purchase through our advertising team.
