|
If its not controlled, chronic heartburn or GERD can result in serious
problems.
Esophagitis
Too much stomach acid in the esophagus can cause a painful and irritating
inflammation of the esophagus. Esophagitis occurs when when
stomach acid repeatedly comes into contact with the lining of the esophagus. If
esophagitis is not accurately diagnosed and treated, the person can develop
Barrett’s esophagus and even cancer.
Esophageal bleeding and ulcers
Esophagitis may cause esophageal bleeding or ulcers.
Barrett's Esophagus
Barrett's esophagus is a serious condition that develops in some people who
have chronic GERD or inflammation of the esophagus (esophagitis).
Damage to the lining of the esophagus --for example, by acid reflux from GERD
-- causes abnormal changes in the cells (called dysplasia) that line the
esophagus. The normal cells that line the esophagus turn into a type of cell not
usually found in the esophagus.
People who have had regular or daily heartburn for more than 5 years may be
at risk for Barrett's esophagus. Symptoms include a burning sensation under the
chest, difficulty swallowing and waking during the night because of heartburn or
acid regurgitation pain, vomiting, blood in vomit or stool, and difficulty
swallowing. Some people do not have any symptoms.
Barrett's esophagus is diagnosed with a test called an upper endoscopy to look at the lining of the esophagus and obtain a
biopsy to examine a sample of tissue. Some doctors recommend that those over age
50 with regular symptoms of heartburn receive an endoscopy to check for
Barrett's esophagus.
Once the cells in the lining of the esophagus have become abnormal, they will
not revert back to normal. The goal of treatment is to prevent further damage by
stopping any acid reflux from the stomach. Proton pump inhibitor medications
like Nexium, Protonix, Prevacid, Prilosec and Aciphex and others are the
mainstay of treatment. These drugs Medications that are helpful include H2 blockers
and proton pump inhibitors, which reduce the amount of acid produced by the
stomach. If these medications do not work, surgery to remove
damaged tissue, or a section of the esophagus or to tighten the sphincter or
"valve" between the esophagus and stomach may be necessary.
Doctors are also now using a newer technique called ablation to destroy the
abnormal tissue. This procedure is usually reserved for those patients at high
risk of developing esophageal cancer. (see below)
Strictures
Sometimes the damaged lining of the esophagus becomes scarred, causing
narrowing of the esophagus. These strictures can interfere with eating and
drinking by preventing food and liquid from reaching the stomach. Strictures are
treated by dilation, in which an instrument gently stretches the strictures and
expands the opening in the esophagus.
Esophageal cancer
Cancer of the
esophagus is a disease in which cancer is found in the tissues of the esophagus.
Cancer that begins in the esophagus is divided into two major types:
- Squamous cell carcinoma
— This type of cancer begins in the special cells—called the squamous
cells—that line the esophagus. This cancer usually affects the upper and
middle part of the esophagus.
- Adenocarcinoma
— This type of cancer develops in the glandular tissue in the lower part of
the esophagus. Glands and glandular tissue are groups of cells that secrete
substances needed by the body.
Esophageal cancer in its early stages often has no symptoms. Difficulty
swallowing is the most common symptom of esophageal cancer. As the cancer grows,
it narrows the opening of the esophagus, making swallowing difficult and/or
painful.
Barett’s esophagus is a pre-malignant condition that may lead to the
development of esophageal cancer in some patients. Approximately 0.4 to 0.5% of
people with Barrett's esophagus will develop esophageal cancer each year.
Because of the cancer risk, people with Barrett's esophagus are screened
surveyed for esophageal cancer regularly.
|
