The Dangers of Chronic Heartburn

Man with symptomatic acid reflux. (Credit: Getty Images)

Most people get heartburn once in a while, especially after eating too much, too late at night or certain types of food. But chronic heartburn, the occurrence of heartburn symptoms daily or weekly over a period of time, can be more than uncomfortable – they could increase your chance of esophageal cancer. 

Robert Yacavone, MD, Director of Endoscopy at Tufts Medical Center, talks about this surprising connection and who is most at risk.

How many people have chronic heartburn and who is most at risk?

Dr. Yacavone: Statistics suggest about 44 percent of American adults will have heartburn at least once a month and at least 18 percent will have heartburn once per week. Chronic heartburn can affect any age group but as we get older we are at greater risk of problems. This is particularly true for older men, or men who are obese. Smoking and alcohol consumption also increase the risk.

What are the symptoms of heartburn?

Dr. Yacavone:  Most people think of heartburn as that burning sensation behind the breast bone.  For some people, symptoms also include the regurgitation of food or fluid backing up from the stomach into the back of the throat. Others may get chest pain, which we need to make sure is not related to a heart problem.  Less typical symptoms include chronic cough and sore throat or difficulty swallowing.

What is Barrett’s Esophagus and why is it a concern?

Dr. Yacavone: Barrett’s esophagus is a condition in which a portion of the lining of the esophagus changes from one type of tissue to another.  Think of a high traffic area in your house where the carpet gets worn down. You may decide to replace that area with a more durable type of flooring, like tile to prevent it from wearing down. That’s what the esophagus does. If an area is bathed with stomach contents over long periods of time, it replaces the surface with a new type of tissue.

The problem is this new tissue forges a welcome mat for cancer cells. Studies have shown that the presence of Barrett’s tissue in the lower esophagus increases the risk of esophageal cancer by 30 to 125 fold relative to patients who do not have Barrett’s.

When should people see a doctor?

Dr. Yacavone: People need to realize that a little bit of heartburn is not necessarily nothing to worry about.  If you’ve had acid reflux over a long period of time, you should discuss it with your primary care physician.  There are good treatments for chronic heartburn including lifestyle changes that can make a difference as well as medications.  You should also discuss whether an upper endoscopy is needed – that’s a simple procedure where a gastroenterologist looks at your esophagus with a special scope. Barrett’s Esophagus is more likely in someone who has had heartburn regularly over many years than someone who has had a lot of heartburn or severe heartburn for a short period of time. So we worry more about Barrett’s in someone who describes once-a-week heartburn for 20 years than someone who has had heartburn three-times-a-week for six months.

Regardless, the key is seeing your doctor before the damage worsens. The prognosis for Barrett’s Esophagus is good if it’s caught early on.

Updated March 2018

The above content is provided for educational purposes by Tufts Medical Center. It is free for educational use. For information about your own health, contact your physician.

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