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What is Barrett's esophagus?

Barrett’s Esophagus (BE) is a condition in which the normal lining of the esophagus changes (metaplasia) due to repeated exposure to stomach acid, non-acidic contents and bile.

Does having Barrett's esophagus increase the risk of developing cancer?

Yes, having Barrett’s Esophagus increases the risk of developing esophageal cancer. The esophagus cells should be closely monitored in order to increase the chance of early detection.

Is difficulty swallowing (dysphagia) associated with esophageal cancer?

There are many possible reasons for difficult swallowing, some of which are serious. If you often have trouble swallowing, you should see a doctor.

What are the possible risk factors for Barrett's esophagus?

Patients who have GERD are at higher risk for developing BE due to increased exposure of the esophagus to stomach content. BE most commonly occurs in caucasian men over the age of 40. The best way to prevent BE is to manage any reflux you are experiencing.

How is Barrett's esophagus treated?

Once the cells of the esophagus change from BE they cannot change back. Treatment includes medication, surgery, or monitoring with frequent endoscopies.

What is Gastroesophageal Reflux Disease (GERD)?

GERD is the movement of gastric contents into the esophagus from the stomach, often described as 'heartburn' or a sensation of burning in the upper abdomen or chest area. It often occurs after a meal, and may be associated with regurgitation (not vomiting, rather a small amount of liquid contents is expelled up from the stomach into the mouth) or acid taste. The gastroesophageal junction normally relaxes on occasion for 'venting' but this may occur more frequently or for longer periods of time, allowing stomach content to enter the esophagus. When the acid reflux becomes frequent or bothersome, it may be classifed as GERD.

Does having GERD increase my risk of getting cancer?

Patients with GERD who also develop a Barrett's esophagus are at an increased risk for developing esophageal cancer. However, GERD patients who do not develop a Barrett's esophagus are at a much lower risk.

Are there any lifestyle changes I can make to help manage my GERD symptoms?

If you are overweight, losing weight may help with reflux. If you experience heartburn while laying down, then elevating the head of your bed may help with symptoms.

There are also some diet modification recommendations for GERD patients. It is advised to avoid eating 3-4 hours before going to bed, and to avoid overating. These foods should be avoided when possible: citrus fruits, tomatoes, onions, carbonated beverages, spicy foods, fatty or fried foods, carbonated beverages, chocolate, and mints. 

What is the usual treatment for GERD?

For the majority of patients, GERD can be treated with lifestyle changes and over-the-counter medications. However, some patients may require perscription medication or surgery.

Do the medications for GERD cure acid reflux or just treat symptoms?

GERD medications do not cure the disease; they work to decrease acid production in the stomach in order to decrease the symptoms of heartburn. Once the use of drugs is terminated, normal production of acid in the stomach will return and it is likely you will begin experiencing heartburn again. If lifestyle changes are not adequate in subsiding symptoms, you may be required to remain on life-long medication.

When should GERD patients consider having surgery?

There is a subset of GERD patients who would benefit from surgery. If you find that after taking medication you are still experiencing bothersome burning or regurgitation of fluid, asthma, voice change, or pulmonary infections then you may be a candidate for surgery. It is important to have a 24 hour pH test to confirm increased acidity in the esophagus which is indicative of GERD. If the test is normal, patients should be tested for other illnesses, as this is not consistent with GERD. Furthermore, if you cannot continue on the medication for other reasons, you also may be a candidate for surgery. 

What does GERD surgery entail?

The surgery attempts to strengthen the lower esophageal sphincter to prevent acid reflux. This is accomplished by wrapping the upper part of the stomach around the lower part the esophagus. 

What are the surgical risks for GERD patients?

5-10% of surgical patients may experience one of the following complications: accidental spleen injury requiring spleen removal, post-operative hernia formation, diarrhea, inability to burp, loosening of wrap, or making the wrap too tight which causes swallowing problems.

Does having GERD increase comorbidity?

GERD may cause other health problems as a result of acid spillover into the throat region or into the lungs. If the acid enters the throat, the patient may experience voice change or a sore throat. If it enters the lungs, cough, asthma, and infections may occur. If the cells lining the bottom of the esophagus are damaged from the acid, then patients may develop Barrett’s esophagus, which increases the risk of cancer.

Are there any medical or physical conditions that increase the risk of developing GERD?

Diabetic patients or those who have recently undergone stomach surgery may develop acid reflux as a result of decreased gastric emptying. Furthermore, an ulcer or cancer can block the stomach from emptying also resulting in increased reflux. Overweight patients may experience reflux due to increased intrabdominal pressure. Lastly, pregnant patients often develop reflux due to increased abdominal pressure from the fetus. Furthermore, certain pregnancy hormones decrease the esophageal sphincter pressure causing reflux. 

For more information on GERD, you can view this link:

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