Why reflux disease isn’t ‘just’ heartburn

Gastroesophageal reflux disease is one of the most common digestive disorders in the world. It happens when acid comes up from the stomach into the esophagus: The stomach can resist acid but the esophagus is less acid-resistant. Dr. James East, a gastroenterologist at Mayo Clinic Healthcare in London, says reflux disease may be common, but there can be severe complications if it is ongoing and left untreated.

Heartburn is a key symptom of reflux disease, but the disease is much more than that.

“Gastroesophageal reflux disease, is when you get acid and chemical damage to the lining of the esophagus,” East says. Some with reflux disease might feel a lump in the throat, have difficulty swallowing, have chest pain, a cough, or have worsening asthma-type symptoms.

“Complications of reflux disease include esophagitis, inflammation in the bottom of the esophagus,” East says. “If this is persistent, you can develop scarring and a stricture,” or narrowing of the esophagus.

If it is persistent and heals, the lining of the esophagus can change to a more acid-resistant form, known as Barrett’s esophagus, a fairly common complication of reflux disease, East says.

Barrett’s esophagus is a condition in which the lining esophagus becomes damaged by acid reflux, which causes the lining to thicken and become red. Over time, the valve between the esophagus and the stomach may begin to fail, leading to acid and chemical damage of the esophagus.

While frequent heartburn may

be a sign, many people with Barrett’s esophagus have no symptoms. Having Barrett’s esophagus does increase your risk of developing esophageal cancer. Although the cancer risk is small, it’s important for people with Barrett’s esophagus to have regular checkups to check for precancerous cells.

Those at highest risk for Barrett’s esophagus include:

■ White men over the age of 50.

■ People with family history of Barrett’s esophagus or esophageal cancer.

■ People who smoke.

■ People with excess abdominal fat.

■ Patients with long-standing reflux lasting more than five years.

“If you have three of those risk factors, then you should have a screening endoscopy for Barrett’s esophagus,” East says.

Treatment for Barrett’s esophagus depends on the extent of abnormal cell growth in your esophagus and your overall health. Treatments in the early stages can include lifestyle measures and medications to help reduce acid reflux and therefore, the esophageal acid exposure.

There are innovative treatments for reflux disease and medications, like proton pump inhibitors. But first, avoid triggers, like coffee, alcohol and smoking.

“If you have severe or frequent reflux disease, you should seek medical advice,” East says.

DREAMSTIME/TNS There are innovative treatments for reflux disease and medications, like proton pump inhibitors. But first, avoid triggers, like coffee, alcohol and smoking.