By Dr. Sunil K. Mathai, Consultant Gastroenterologist, Medical Trust, Kochi
Heartburn is a common health problem. Many tend to take it lightly, often seeking only temporary relief and ignoring the condition. But if gastric problems keep recurring, they cannot be dismissed as minor.
Persistent heartburn and acidity could be signs of Gastroesophageal Reflux Disease (GERD). This digestive disorder occurs when stomach acid or bile flows back into the esophagus. Such backflow irritates the lining of the esophagus. While occasional heartburn is common, if it occurs frequently and causes difficulty in the esophagus, GERD may be suspected. Common symptoms include heartburn, regurgitation of sour food or liquid, and difficulty swallowing. Continuous irritation can lead to swelling, ulcers, and bleeding in the esophagus. GERD can also cause insomnia, fatigue, and difficulty concentrating.
Through lifestyle changes and proper treatment, GERD can be controlled. However, if left untreated for a long time, it may lead to serious health problems. Continuous irritation from stomach acid can cause chronic inflammation and damage to the esophagus. Over time, this persistent irritation may develop into a condition called Barrett’s Esophagus.
Barrett’s Esophagus is a precancerous condition in which cells similar to those of the intestinal lining replace the normal cells of the esophagus. Although Barrett’s itself is not cancer, it increases the risk of developing a type of cancer called esophageal adenocarcinoma, which starts in the glands of the esophagus. The risk is higher in those with long-term GERD, in patients who neglect treatment, and in those already diagnosed with Barrett’s Esophagus.
Unhealthy lifestyle habits, obesity, smoking, and family history also increase the risk of this cancer.
For those with chronic GERD and those diagnosed with Barrett’s Esophagus, regular monitoring and treatment are essential. Endoscopy is recommended to examine the esophagus and collect tissue samples. Detecting precancerous changes early makes timely treatment possible and significantly reduces the risk of cancer.
Prevention and Treatment
Lifestyle changes : Maintain a healthy weight, avoid spicy, fatty, caffeinated, and acidic foods, and quit smoking.
Monitoring: Patients with Barrett’s Esophagus should undergo endoscopy at regular intervals. This helps in detecting early cancerous changes.
Endoscopic treatments:
Endoscopic Mucosal Resection (EMR) and Endoscopic Submucosal Dissection (ESD) are treatment methods used for early-stage gastric and esophageal cancers.
Surgery : In severe cases, procedures like fundoplication strengthen the lower esophageal sphincter (the valve at the lower end of the esophagus) to reduce acid reflux.
GERD is not just simple heartburn. If left untreated, it can progress to Barrett’s Esophagus and even esophageal cancer. Early recognition of symptoms, lifestyle modifications, proper medication, and regular monitoring can reduce risks and prevent cancer.