The Relationship Between Chronic Heartburn and Cancer

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    Endoscopic radiofrequency ablation is an innovative, minimally invasive outpatient procedure that can keep chronic heartburn from turning into cancer. Stony Brook University Digestive Disorders Institute gastroenterologist Dr. Satish Nagula, who has advanced training and years of experience in the procedure, explains.

    What is the concern about chronic heartburn?

    Occasional heartburn is nothing to worry about. But frequent acid indigestion — that is, burning pain two or more times a week in the lower middle chest behind the breastbone — can be a sign of gastroesophageal reflux disease (GERD). Left untreated, GERD can have serious complications including Barrett's esophagus, which, in turn, may lead to esophageal cancer. It's important to evaluate long-term GERD for the risk of developing Barrett's esophagus.

    What should we know about Barrett's esophagus?

    Barrett's esophagus involves cellular changes in the lining of the esophagus — the muscular tube connecting the mouth and stomach. In a small percentage of patients with GERD, stomach acid injures the esophageal lining, causing inflammation and genetic changes that, over time, can become cancerous. Although Barrett's esophagus can occur in anyone, GERD is the number one risk factor. Because Barrett's esophagus is symptomless, the only way to detect this condition is by endoscopic evaluation.

    Is it true that esophageal cancer is on the rise?

    Yes. Esophageal adenocarcinoma, which occurs in the lower part of the esophagus, not only is the fastest growing cancer diagnosis in the United States, but also is one of the most deadly. We're not sure why this cancer has increased fivefold in the last 30 years or so, but rising rates of obesity — and the accompanying increase in GERD and Barrett's esophagus — may be a factor. Demographically, esophageal cancer occurs most often in white males age 55 and older. The good news: We can help prevent many esophageal cancers by eradicating precancerous tissue through an innovative outpatient procedure.

    How does endoscopic radiofrequency ablation work?

    It involves an endoscope — a small tube that we pass through the mouth into the esophagus. Through it, we guide in an electrode-covered balloon. When we reach the target area, we inflate the balloon and deliver a tiny burst of controlled energy through the radiofrequency electrodes to destroy the abnormal tissue. Stony Brook is currently the only hospital in Suffolk County to offer this treatment.

    What are the advantages for patients?

    It's safe, convenient and effective. Patients may have two or three treatments over the course of several months. They go home the same day with no side effects other than a bit of chest discomfort that disappears after a few days. According to clinical studies, in most patients this treatment completely eliminates the precancerous tissue associated with Barrett's, and keeps it in remission for at least five years. We continue to monitor our patients with Barrett's using periodic endoscopy to make sure.

    For more information about Endoscopic radiofrequency ablation, or to make an appointment with an gastroenterologist, call (631) 444-4000.

    GERD Facts

    Signs and Symptoms: Heartburn, regurgitation of acidic fluid (acid reflux), a sour taste in your mouth and difficulty swallowing are the most common GERD symptoms.

    What Happens: As you swallow, a circular band of muscle around the bottom part of your esophagus, the
    lower esophageal sphincter (LES), relaxes, allowing food and liquid to flow into your stomach. It closes again to prevent food juices from returning (refluxing) into the esophagus. GERD occurs when the LES muscle fails to operate properly and the acid in your stomach backs up, irritating the lining of your esophagus. Evaluation: If you've been diagnosed with GERD or have had undiagnosed heartburn twice a week or more for at least six months, check with your physician, who can refer you to a gastroenterologist or Stony Brook's Endoscopy Program for an evaluation.

    About Stony Brook University Digestive Disorders Institute
    Stony Brook Digestive Disorders Institute is staffed by an expert team of board-certified gastroenterologists and hepatologists who perform both routine and advanced diagnostic tests and procedures using the latest technology and state-of-the-art techniques. For more information, call (631) 444-4000.
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