Summary

Original source:
http://www.news-leader.com/apps/pbcs.dll/article?AID=/20051129/LIFE04/511290305/1035

Details

• The vast majority of people with heartburn won't suffer such a serious complication, but there is little guidance on how to find out who is most at risk.
• The most obvious sign --- a change in the lining of the esophagus --- has no symptoms beyond those of the underlying heartburn.
• As many as 12 percent of the estimated 15 million GERD sufferers will develop Barrett's esophagus, and from 5 percent to 10 percent of those will go on to develop cancer.
• Barrett's may be diagnosed with an endoscopy --- sliding a lighted tube down the throat to get a better look at the esophagus.
• Some researchers have suggested a one-time screening for anyone who has chronic reflux, particularly if the problem is serious enough to warrant long-term drug therapy.
• Others believe only those at highest risk should be screened --- white men older than 40 or 50 who have suffered reflux symptoms at least twice a week for five years.
• Patients who develop GERD for the first time after age 65 should also consider screening.
• Heartburn drugs aren't specifically approved for long-term use, but many doctors encourage patients to use them indefinitely.
• Questions remain about whether the drugs, which suppress acid production, cause changes in the gastric environment that might increase cancer risk.
• "We need to treat heartburn well and with whatever the best method is, and currently that is PPIs," says Scott Swanson, chief of thoracic surgery at Mount Sinai School of Medicine in New York.
• Antireflux surgery to tighten faulty valves or repair hernias at the base of the esophagus can also stop chronic reflux, by helping prevent stomach acids from sloshing upward into the esophagus.
• Cut back on chocolate, spicy foods, tomato sauce, orange juice, peppermint, onions, soft drinks and other foods linked with heartburn.

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