Heartburn, acid reflux, GERD, and
Barrett’s Esophagus are all disorders caused by stomach acid moving up into the esophagus.
Most people are familiar with the terms heartburn and acid reflux, but don’t know how it can develop into severe medical problems such as GERD and Barrett’s esophagus. Heartburn is an uncomfortable warm and burning sensation in the chest, usually just behind the sternum (breastbone) that typically comes in waves. The pain may start in the chest area and make its way up to the neck, throat and jaw. The pain usually gets worse when the patient lies down or bends over, and is more common immediately after eating.
Many people experience these symptoms on a weekly basis, while most people experience it at least once annually. This is what people commonly refer to as heartburn or acid reflux. GERD, however, is a more severe disorder where acid reflux is more constant and the stomach acid begin to deteriorate the esophagus and/or lower esophageal sphincter (LES).
Barrett’s Esophagus is a severe medical condition relating to the esophagus, as a direct result from prolonged acid reflux and GERD.
What is Heartburn?
The condition is medically known as pyrosis or acid indigestion. The word “heartburn” is a common term to describe the symptoms, but it has nothing to do with the heart. It is commonly called heartburn because the sensation of burning can be felt near the area of your heart.
If heartburn symptoms are experienced frequently and affect your daily routine, you need to check with a doctor to ensure that you aren’t experiencing symptoms of something worse.
Symptoms of Heartburn
Up to 60 percent of the population at some time during the year, and 20-30 percent weekly, experience symptoms of gastroesophageal reflux disease (GERD), such as heartburn and acid regurgitation.
These symptoms include:
- Hoarseness or sore throat
- Frequent swallowing
- Asthma or asthma-like symptoms
- Pain or discomfort in the chest
- Sleep disruption (unable to sleep lying down)
- Excessive clearing of the throat
- Persistent cough
- Burning in the mouth or throat
- Intolerance of certain foods
- Dental erosions or therapy-resistant gum disease or inflammation
What is GERD?
Gastroesophageal Reflux Disease (GERD) is similar to heartburn or acid reflux, but is worse. It’s a digestive disease that causes the content in your stomach to flow back up the esophagus like heartburn, but more frequently. When functioning normally, the lower esophageal sphincter (LES) will usually prevent this from happening but if the LES is affected, the backwash of acid will irritate the lining of your esophagus and cause severe pain.
Factors that may contribute to LESS dysfunction and potentially GERD are:
- Hiatal hernia
- Over age 40
- Medicines that delay gastric emptying
- Obesity (BMI over 30)
- Morbid obesity (BMI over 40)
- Alcohol abuse
How Does Barrett’s Esophagus Differ from GERD or Acid Reflux?
Chronic heartburn or frequent acid reflux can cause an esophageal condition known as “Barrett’s esophagus.” The esophagus is the tube used to carry food and liquid into the stomach and a person who has acid reflux or GERD has a weakened esophageal sphincter (the barrier that keeps food, liquid, and acid from coming back up into the esophagus). The acid from the stomach refluxes into the esophagus – burning the tissue and causing moderate to extreme discomfort.
Those with severe acid reflux may develop Barrett’s, which begins when stomach acid chronically refluxes and damages the tissue in the esophagus. This causes the esophageal tissue to change into intestinal-type tissue and can lead to cancer of the esophagus if not treated early.
Barrett’s esophagus affects a little over three million adults over fifty years old in the United States and esophageal cancer has increased six times since 1970 – faster than breast cancer, prostate cancer, or melanoma. Barrett’s esophagus is diagnosed by passing a small scope through the mouth and into the esophagus where a biopsy of the affected tissue is taken. The biopsy is then examined by a pathologist to confirm the diagnosis and grade the severity of cellular changes (dysplasia). The severity of cellular change can range from Barrett’s esophagus (normal esophagus cells have changed to intestinal cells), to Low-grade Dysplasia (abnormal cells are beginning to change in size and shape), High-grade Dysplasia (abnormal cells are becoming more pronounced), and Adenocarcinoma (Esophageal cancer). Following the procedure, the patient may experience minor discomfort, which can be managed by medication. Acid suppression is usually prescribed by the physician to prevent damage to the new tissue.
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