What’s the worst consequence of acid reflux?
It’s Not Just Nighttime Waking…It Could Be Esophageal Cancer
The stereotype of a person with acid reflux might be a heavyset middle-aged guy who eats a steady diet of beer, sausage and cheese – kind of like Larry the Cable Guy (who happens to be the spokesman for acid reflux medication Prilosec®). But it’s just a stereotype – reflux affects a wide range of people.
“It can be an 18 year old guy who is thin as a rail who has horrible reflux, and lots of women have reflux, too – it’s not necessary to be an obese man to have reflux,” said Dr. Jared Brooks, a surgeon with Sentara Surgery Specialists in Norfolk.
Approximately 7 million people in the United States have some symptoms of gastroesophageal reflux disease (GERD) and 20 percent have pathological reflux – which may have serious consequences. GERD and acid reflux cause a surprising number of hospitalizations and even some fatalities, mainly due to esophagitis, which is inflammation of the esophagus. Left untreated, esophagitis can lead to esophageal cancer.
One misconception is that taking medication is protective against the inflammation and, in some cases, progression to abnormal tissue (Barrett’s esophagus) that can become cancerous due to longstanding esophageal exposure to gastric juices.
“The way that proton pump inhibitors (PPIs) work is by stopping acid production by the stomach, but that does not stop the reflux of stomach contents into the esophagus (in people with reflux); it just renders the fluid non-acidic. In some cases this eliminates the symptoms of reflux but does not prevent the development of an inflamed esophagus, masking a dangerous condition,” Brooks said.
Dr. Brooks noted that PPI use has increased significantly in the last 30 years but the incidence of esophageal cancer has also increased significantly. This indicates the medications are not impacting the disease at its source and that’s why a surgical solution may be a better choice for people at higher risk.
Unfortunately, having your symptoms under control doesn’t mean “out of the woods” when it comes to esophageal cancer risk. With the number of people experiencing moderate to severe symptoms even while on medication, this should be monitored carefully.
“You can still be developing esophagitis. Even with good symptom control, you need to go see a GI doc for an endoscopy every 5 or 10 years to monitor it,” Brooks said.
Dr. Brooks recommends the LINX procedure because it does prevent the reflux of all gastric contents, not simply eliminating the acid from the gastric contents that continue to bathe the lower esophagus when taking PPI’s.
“LINX can offer sustained control, rather than continually taking proton pump inhibitors, and it helps keep the gastric contents from refluxing into the esophagus by keeping it closed with a band of magnetic beads,” he said. “We think this may have lots of utility going forward, and may be able to help with arresting the inflammatory process that leads to esophageal cancer in some people with reflux. “
Dr. Brooks, along with colleague Dr. Bethany Tan, are the first surgeons in Hampton Roads to be trained and able to offer the LINX procedure. The LINX procedure was approved in 2012 by the FDA, and now has 10 years of data to support the claims that it’s effective in reducing acid reflux and GERD symptoms.