Posted: Monday, February 21, 2022

Acid Reflux and Barrett's Esophagus

Acid reflux is a condition that affects millions of Americans. It’s so common that nearly 20 percent of American adults experience acid reflux at least twice a week. It occurs when the valve between the stomach and the esophagus does not close properly, resulting in contents in the stomach backflowing into the esophagus. And while there are ways to mitigate it, longstanding inflammation as a result of ongoing acid reflux can result in the development of Barrett's esophagus, a condition in which the lining of the esophagus food pipe changes to resemble the lining of the small intestine near the area where the esophagus and the stomach join. It is estimated that between 40 and 50 percent of Americans who suffer from gastroesophageal reflux disease, or GERD, could develop Barrett's esophagus.

Blount Memorial gastroenterologist Dr. Sirisha Jasti says white men 50 or older are at a higher risk for developing Barrett’s esophagus. “Some other risk factors for the development of Barrett's esophagus include chronic reflux; a hiatal hernia; metabolic syndrome; obesity; a family history of acid reflux or esophageal cancer; smoking; and consumption of red meat and processed meat,” Jasti said. “While most patients with Barrett's esophagus do not develop cancer, due to the chronic ongoing inflammation, it can result in precancerous condition for the development of esophageal adenocarcinoma in a small percentage of patients. Barrett's esophagus patients do, however, have approximately a 0.3-0.6 percent chance of their disease progressing to cancer each year,” she explained. “Some studies suggest that progression risk is cumulative over time, reporting progression to precancerous lesions or cancer in seven percent of Barrett's esophagus patients at the 10-year mark,” she said. 

“Esophageal adenocarcinoma is one of the fastest rising cancers, and is a highly lethal cancer associated with a five-year survival rate of just 15-20 percent, as well as an overall median survival of less than one year in cases with advanced disease,” Jasti continued. “We know that there is a stepwise progression in patients with Barrett's esophagus to esophageal cancer. Unfortunately, about 40 percent of esophageal cancer patients are still diagnosed in late stages,” she added.

Fortunately, Jasti says getting the problem under control early can lead to dramatically better results. “Medicines and/or surgery can effectively control the symptoms of acid reflux,” Jasti said. “However, once Barrett's esophagus develops, neither medications nor surgery can fully eliminate the risk for cancer. As such, early diagnosis, surveillance and definitive treatment of Barrett's esophagus using endoscopic techniques gives us the opportunity to change the course and outcomes of this disease. We have the expertise to help patients manage Barrett's esophagus here at Blount Memorial Hospital, especially in the setting of precancerous lesions using a technique called ‘ablation,’ in which we apply heat using radiofrequency energy. This technology uses an electric current and optimizes the removal of diseased tissue while minimizing injury to the normal esophageal tissue,” she explained. “This treatment typically is performed in an outpatient setting without the involvement of surgery. Clinical studies have demonstrated that Barrett's esophagus tissue can be completely eliminated with this ablation system in more than 90 percent of patients,” she added.

For more information about treatments for acid reflux or Barrett’s esophagus, or to schedule an appointment with Dr. Jasti, call Blount Memorial Physicians Group – Gastroenterology at 865-980-5060.

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