Why Heartburn or Reflux can Cause Cancer

Heartburn occurs when fluid splashes back up from the stomach into the esophagus, the long feeding tube that connects the stomach and throat, sometimes causing a burning sensation.

Before it Becomes Cancer – Barrett’s Esophagus

Over time, the persistent reflux bath can cause normal skin-like cells in the esophagus to change into tougher, more acid-resistant cells of the type found in the stomach and intestine, a condition called Barrett’s Esophagus.  Once Barrett’s Esophagus is diagnosed, patients have a 30- to 125-fold increased risk of developing esophageal cancer.

In research from scientists at University of Texas Southwestern Medical Center and the Dallas Veterans Affairs Medical Center, researchers discovered that people with acid reflux disease, particularly those with a complication of acid reflux called Barrett’s esophagus, have altered cells in their esophagus containing shortened telomeres, the ending sequences in DNA strands. Combined with related research, the findings indicate that the shortened sequences might allow other cells more prone to cancer to take over.

More details about Barrett’s Esophagus
An award winning video series from the Mayo Clinic explains what Barrett’s Esophagus is and how to treat it.

The Most Common Type of Esophageal Cancer in the US

Twenty years ago, the most common type of esophageal cancer was squamous cell carcinoma, which arises from the squamous mucosa that lines the normal esophagus. But in the past 20 years, there has been a 350 percent increase in adenocarcinoma of the esophagus, a type of cancer that is related to the cellular changes in the esophagus that are the hallmark of Barrett’s Esophagus and arise from gastroesophageal reflux disease.

It is now the most common form of esophageal cancer, occurring in 80 percent to 90 percent of patients. Medical experts point out that this increase in esophageal adenocarcinoma mirrors the rise of the obesity epidemic.   According to estimates put forth in a study published in the American Gastroenterological Association (AGA) journal Gastroenterology, more than 3 million Americans are living with Barrett’s esophagus, a condition that can lead to esophageal cancer.

Esophageal Cancer Happens Even Without Reflux Symptoms or When Symptoms Disappear

According to study findings, Barrett’s was nearly twice as prevalent in people with symptoms of reflux and those who had esophagitis than those who did not. However, more than 40 percent of those who presented with the disease had no prior symptoms of reflux–giving credence to the theory that Barrett’s can significantly impact people who present with no symptoms and that screening only those with reflux will not effectively capture all cases.  And the risk of developing cancer may be even greater for patients who once experienced heartburn or other symptoms of reflux and then discover that those symptoms have gone away.  It may be a sign that the tissue lining the esophagus has gotten accustomed to the reflux and has changed to resemble the lining of the stomach.

How to Detect ‘Silent Reflux’

‘Silent reflux’ may be the cause of sleep disturbances in patients with unexplained sleep disorders.  Some researchers recommend that all patients with sleep apnea should be evaluated for gastroesophageal reflux. In addition, many people may not realize that symptoms such as chronic cough, choking, hoarseness or chest pain can be caused by reflux disease, because they do not experience classic heartburn symptoms or regurgitation.