Barrett’s esophagus, acid reflux and esophageal cancer

Esophageal cancer risk can be increased by a history of smoking, drinking, obesity, and the human papillomavirus, HPV. But it’s also associated with acid reflux disease and a syndrome called Barrett’s esophagus.

Acid reflux is when acidic fluid is regurgitated into the esophagus, causing heartburn. If you are experiencing acid reflux or if you’ve been diagnosed with Barrett’s esophagus, it’s important to take steps that may lower your esophageal cancer risk and identify cancer at an earlier stage.

“Esophageal cancer is often found late, after symptoms develop and when it’s more difficult to cure. But when esophageal cancer is diagnosed early, treatment is likely to be more effective, “says Mara Antonoff, M.D., assistant professor of Thoracic and Cardiovascular Surgery.

What is Barrett’s esophagus and how is it diagnosed?

Barrett’s esophagus is a complication of acid reflux. It occurs when acid from the stomach frequently backs up into the esophagus and damages the tissue in the lining. This makes this tissue look more like the tissue of the intestinal lining.

Ask your doctor about your risk of developing Barrett’s esophagus, if:

• You’ve had trouble with heartburn for more than five years
• You’ve had acid reflux for more than five years
• You’ve had difficulty swallowing

Even if you used to experience acid reflux, but no longer do, it’s important to talk to your doctor. Sometimes symptoms will stop showing because the body becomes used to producing larger amounts of acid.

Approximately 1 in 6 Americans experience reflux symptoms weekly, and about 10% of those have Barrett’s esophagus. Barrett’s-related esophageal cancer strikes about 10,000 Americans each year.

Barrett’s esophagus is diagnosed with an endoscopy. During an endoscopy, a lighted tube with a camera called an endoscope is passed down the throat to look for symptoms. Then, a biopsy is performed by removing a small piece of tissue from the esophagus.

How can you lower your esophageal cancer risk?

Esophageal cancer screening

Getting regular endoscopies is important if you’ve had the symptoms listed above. In addition to helping doctors diagnose Barrett’s esophagus, endoscopies can also help doctors catch esophageal cancer in its earliest stages. Your doctor will help you determine how often you need to have endoscopies.

There are several other ways you can reduce your risk for esophageal cancer.

Eat a healthy diet

Often, acid reflux symptoms can be eased by changing the way you eat. Certain foods that are common in Western diets – like chocolate, alcohol, coffee and foods with a high fat content - are more likely to weaken the lower parts of the esophagus and lead to acid reflux.

“One bite of chocolate won’t necessarily give you reflux or increase your cancer risk, but it’s important to consume these foods in moderation,” Antonoff says.

Esophageal cancer has also been associated with diets high in processed meats, so be sure to avoid them and watch your portion sizes at meal time.

Work with your doctor to find the right medications

Over-the-counter antacids can help manage acid reflux. But if symptoms continue, your doctor may recommend prescription medications.

Two types of prescription medications that treat acid reflux include:

• Histamine blockers, also called H2 blockers: These cut down on the amount of acid produced by the stomach by targeting a substance called histamine, which is released by your immune system.
• Proton pump inhibitors (PPIs): These also cut down on the amount of acid produced by blocking the enzymes in the stomach wall that make acid. 

If symptoms continue with medication, doctors may recommend surgery to help relieve acid reflux.

Avoid tobacco and alcohol

Both smoking and drinking alcohol increase risk for esophageal cancer.. Smoking is also the top cause of lung cancer. If you smoke or use tobacco, there are a number of resources available to help you quit.

Alcohol consumption increases a person’s risk for a number of cancers, including breast and liver cancers. The National Cancer Institute recommends that women have no more than one alcoholic drink per day and men have no more than two drinks per day. Alcoholic drinks come in three forms: beer, wine and liquor. A drink serving is defined as 12 ounces of beer, five ounces of wine or 1.5 ounces of liquor.

Making basic healthy lifestyle choices can alleviate the symptoms of Barrett’s esophagus and acid reflux. In many cases, the effects of acid reflux can be reversed, and your cancer risk reduced significantly.