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Hard to swallow: Facts about GERD and esophageal cancer

By Dr. Maher Salam • Oct 7, 2017 at 6:00 PM

As many of you may know, acid reflux or heartburn is that uncomfortable feeling that something you ate is coming back up. It can feel like a burning sensation — or even pain — behind the sternum. It happens when the contents in your stomach flow upward into the esophagus because the valve between the two organs doesn’t close properly.

If it happens often enough, you have what’s called gastroesophageal reflux disease, or GERD. An estimated 18 to 28 percent of adults in the United States experience frequent acid reflux—a condition that’s made worse by obesity, smoking, excessive alcohol use and a poor diet. More than half of all pregnant women also report severe heartburn, although it usually disappears after childbirth.

Symptoms of GERD

GERD can begin as a burning pain in your chest, often after a big meal. It might move upward toward your neck and is often accompanied by a feeling of food coming back into your mouth. Other symptoms include:

• Heartburn

• Reflux

• Fluid coming back into the mouth

• Difficulty swallowing

• Chronic hoarseness, sore throat, throat-clearing or coughing

• Chronic sinus problems

• Vomiting

• Asthma or wheezing

• Gas, belching, bloating or indigestion after meals

Risks of esophageal cancer

Esophageal cancer is a disease in which malignant cells form in the tissue of the esophagus. Risk factors include smoking and heavy alcohol use, but there can be a ‘domino effect’ related to some of these risk factors that some people may not take seriously. For example, along with smoking and alcohol use, obesity and poor diet can lead to the common digestive condition, GERD.

Untreated, GERD can irritate the esophagus and, over time, cause a more serious condition known as “Barrett esophagus,” in which the cells lining the lower part of the esophagus change or are replaced with abnormal cells. Those abnormal cells can ultimately become esophageal cancer, and change from serious to deadly.

Esophageal cancer is often diagnosed at an advanced stage because there may be no early signs or symptoms. When they do appear, symptoms can include painful or difficulty swallowing, weight loss, indigestion and heartburn.

About 50,000 people live with esophageal cancer in the United States, according to the National Cancer Institute. There will be an estimated 16,940 new cases of esophageal cancer in the United States in 2017 and an estimated 15,690 deaths. Other than having GERD, risk factors for the disease include smoking, drinking alcohol and being obese.

Getting GERD symptoms under control

A case of heartburn or acid reflux here or there is likely nothing to worry about. But if you begin experiencing it on a regular basis, it’s time to get help.

Luckily, most GERD symptoms can be managed with lifestyle modifications, such as avoiding large meals late in the day, quitting smoking, losing weight, and cutting back on foods that trigger GERD. While these foods can be different for everyone, common culprits include acidic foods like citrus and tomatoes, spicy foods, chocolate, coffee and fried and fatty foods. It can also help to avoid lying down after eating, sleep in a slightly upright position and take a short walk after a meal.

If you’re struggling with GERD, learn more about how the Fisher-Titus Heartburn Center can help. Visit fishertitus.org or call 419-660-4300.

EDITOR’S NOTE: Dr. Maher Salam is a fellowship-trained gastroenterologist who practices at Bay Area Digestive Health, 282 Benedict Ave., Norwalk.

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