Acid reflux is relatively common – about 20% of the U.S. population develop it at some point during their lifetime. Yet it’s a condition you shouldn’t ignore. If left untreated, acid reflux could lead to esophageal cancer.
“When the cells of the esophagus are continuously exposed to gastric acid – which occurs when you have chronic reflux – those cells can shift, leading to a condition called Barrett’s esophagus, which can cause precancerous lesions to form,” says Corbin Cleary, M.D., a thoracic surgeon at Henry Ford Health.
What’s The Likelihood Of Developing Barrett’s Esophagus?
About 5.6% of people with reflux develop Barrett’s esophagus and around 5% of those with Barrett’s esophagus develop esophageal cancer. Acid reflux and Barrett’s esophagus are more common in men – and especially men who are obese, says Dr. Cleary, which could partly be due to increased pressure on the abdomen that can lead to reflux.
“Not everyone who has acid reflux needs to be examined for Barrett’s esophagus,” says Dr. Cleary. “However, if you’ve had untreated reflux for about 5 to 10 years (or more), talk to your doctor about getting an endoscopy to examine your stomach lining for precancerous lesions. This is important because Barrett’s esophagus is often asymptomatic.”
There are a few different stages of Barrett’s esophagus:
Managing Acid Reflux
- No dysplasia, meaning you have Barrett’s esophagus but no precancerous lesions. Typically, those with no dysplasia can be monitored with repeat endoscopy.
- Low-grade & high-grade dysplasia, meaning you have Barrett’s esophagus and some (or many) precancerous lesions. Endoscopy can be used to remove lesions.
When It’s Cancer
The type of esophageal cancer that’s more common in obese men and those with reflux is called adenocarcinoma. Another type, called squamous cell carcinoma, is associated with smoking and alcohol usage.
“While the amount of people who develop squamous cell carcinoma has been steady, the rate of adenocarcinoma has been rising, and we think that’s partly because the rate of obesity has been rising,” says Dr. Cleary.
Unfortunately, esophageal cancer is often asymptomatic until it’s advanced. By the time symptoms occur like weight loss or difficulty swallowing, it can be difficult to treat. “This is why early surveillance and observation of Barrett’s esophagus is important,” says Dr. Cleary.
Managing Acid Reflux
Managing acid reflux is the best way to reduce your risk of Barrett’s esophagus and, in turn, esophageal cancer.
“Losing weight is the first line of treatment for acid reflux, along with taking medications like protein pump inhibitors and making dietary changes. For example, avoiding spicy foods and excessive caffeine,” says Dr. Cleary. “If this doesn’t work, surgery can be performed to create a new barrier for the stomach.”
Reviewed by Corbin Cleary, M.D., a thoracic surgeon who sees patients at Henry Ford Hospital in Detroit and Henry Ford Medical Pavilion – Macomb.
