In 2009, GI Specialists of Georgia treated 8,178 patients with Reflux Esophagitis and 803 with Barrett's Esophagus.
Reflux esophagitis, also referred to as GERD (gastro-esophageal reflux disease) has recently received a great degree of attention. It's in the news and on commercials. Although it is a condition rather than a disease, reflux has been around forever, however, much can be done to control symptoms and improve the quality of life of those who are affected by it.
Approximately 20% of American adults suffer from reflux symptoms. Reflux, or heartburn, often causes symptoms but in other individuals may be asymptomatic. At times it may cause atypical symptoms such as chest pain, respiratory symptoms such as asthma, chronic cough and hoarseness. For some individuals, GERD causes respiratory symptoms, which can cause or worsen asthma-like conditions or cause a series of problems in the larynx. These patients typically consult us because they have a chronic cough or complain of chronic hoarseness.
To understand reflux, you should know that hydrochloric acid is produced in the stomach. It has a series of functions, mainly initiating the process of digestion. The stomach can defend itself from the low pH of acid, but this is not the case with the esophagus. Because of this, there is a sphincter (lower esophageal sphincter or LES), which acts like a barrier so that most of the acid is kept away from the esophagus. Some people have a low sphincter pressure and will have more frequent episodes of relux. Some conditions such as heavy alcohol ingestion, smoking, obesity, ingestion of high fat containing meals will worsen reflux. All Americans suffer once in a while from reflux, but when this becomes a weekly or daily condition, patients feel their quality of life is impaired and seek therapy.
Esophageal cancer (Adenocarcinoma) affected 6000 to 8000 Americans in the year 2000. Over the last thirty years, esophageal cancer has increased over 350%, the most rapidly rising incidence than all GI cancers. Esophageal cancer arises most often in patients who have a condition known as Barrett’s esophagus.
Barrett’s esophagus is considered by many to be a premalignant precursor to esophageal cancer. The exact prevalence of Barrett’s esophagus in our country is unknown but if one considers that close to 20% of adults suffer from reflux and 10 to 15% of patients with chronic reflux will have Barrett’s esophagus, one could predict that up to 1 to 2% of American adults could develop Barrett’s, contributing to the rise of esophageal cancer.
People who are at higher risk of Barrett's esophagus are those who have had reflux symptoms for more than 10 years. Caucasian males, especially those of 45 and above, should undergo an upper gastrointestinal endoscopy, also known as an EGD (esophago-gastroduodenoscopy). During this procedure, your doctor will determine how severe your reflux is and will usually be able to tell you if you have developed Barrett’s esophagus or not. If you do have Barrett’s, treatment of heartburn is usually a bit more aggressive and for a longer period of time. If you are found to have Barrett’s esophagus, you will likely need surveillance endoscopies to follow up on your condition, in a frequency to be determined by your gastroenterologist.