By Irteza Inayat, M.D.
Acid reflux is extremely common today. Its main symptom, heartburn, affects as many as 15 million people daily. But the mere fact that it’s common doesn’t mean you should take it lightly. Acid reflux (technical name gastroesophageal reflux disease, or GERD) can lead to much more serious conditions, and even to cancer, if untreated. Fortunately, there are treatments that can relieve acid reflux itself – and cure its most common complications. If you experience chronic heartburn, here is what you should know.
What is acid reflux?
Acid reflux is a flow of acid from the stomach upward into the esophagus – the muscular tube that delivers food to the stomach. The condition happens when the valve that normally seals off the esophagus from the stomach becomes relaxed. People with persistent acid reflux experience frequent burning pain in the lower chest and middle abdomen (heartburn) and may have a bitter taste in the throat. Some people with the condition do not have heartburn but experience a dry cough, asthma symptoms, or trouble swallowing.
What causes acid reflux?
The causes are unclear, although abnormalities such as a hiatal hernia, may contribute. Other factors may include obesity, pregnancy, or smoking.
How is acid reflux treated?
The first treatments are changes in lifestyle and diet. These include eating smaller and more frequent meals, and limiting foods such as citrus fruits, chocolate, caffeinated or alcoholic drinks, fatty and fried foods, and spicy or acidic foods.
Some people’s symptoms may be relieved by common antacids that help neutralize stomach acid, or by prescription or over-the-counter medications called proton pump inhibitors that limit production of acid in the stomach. Medications should be taken under the supervision of a doctor, who can monitor the effects and decide whether further treatment might be needed. If acid reflux occurs frequently or causes complications, then it is necessary for a doctor to make a definitive diagnosis and develop a treatment plan.
Can treatment for chronic acid reflux include surgery?
In some cases, yes. For people with uncontrolled symptoms, or with complications, surgery can be better than lifelong medication and discomfort. The standard treatment for acid reflux is called Nissen fundoplication, in which the valve between the esophagus and the stomach is strengthened to keep acid from escaping up into the esophagus. This can be done in minimally invasive manner so that patients heal quickly. Other techniques are being developed.
What are the complications of acid reflux?
When the esophagus is exposed repeatedly to stomach acid, cells in the esophagus lining can undergo a genetic change, becoming like the cells of the stomach lining. This condition is called Barrett’s esophagus. If left untreated, these abnormal cells can change further, leading to cancer of the esophagus – the fastest-growing cancer in the United States and often very difficult to cure. At present, only 16 percent of patients with esophageal cancer survive for five years or more.
How common is Barrett’s esophagus?
It is estimated that 3 million people in the United States have Barrett’s esophagus. Many are not aware that they have the condition.
Can Barrett’s esophagus be treated before it leads to cancer?
Yes. A treatment called radiofrequency ablation (RFA) can remove the disease quickly, safely and effectively. It treatment is available at [Hospital Name].
How does RFA therapy work?
The doctor uses a slender tube with a tiny camera, called an endoscope, to look into the esophagus and pinpoint the disease location. The doctor then directs a device called an ablation catheter to the diseased area and activates an energy generator to deliver a rapid burst of energy that removes a very thin layer of diseased tissue. The procedure is tightly controlled to avoid injury to the normal, healthy underlying tissue. Studies show that in most patients, new healthy tissue replaces the removed tissue in three to four weeks.
Does RFA therapy require a stay in the hospital?
No. The procedure typically takes less than 30 minutes, needs no incisions, and is performed with the patient under conscious sedation in an outpatient setting. Some patients have minor discomfort afterward that is easily managed with medication.
Irteza Inayat, M.D. is Assistant Clinical Professor of Medicine at UCF College of Medicine and Staff Gastroenterologist at Osceola Regional Medical Center in Kissimmee. He may be contacted by calling (407) 846-2266 or 800-447-8206 or by visiting www.OsceolaRegional.Om .