Understand risks, options with GERD

Acid reflux



Most people think of heartburn as just an annoying discomfort, but when it’s a symptom of ongoing acid reflux, there are associated risks most people aren’t aware of.

If you are one of the millions who suffer from daily symptoms of acid reflux, also known as GERD—gastro-esophageal refl ux disease—you already know the impact on your quality of life.

Some sufferers can’t lay down flat to sleep or enjoy the foods they once loved. But few truly understand the risks of ongoing acid reflux and of the medications commonly used to treat it. Understanding these risks will help you make informed decisions.

The repetitive wash of acid coming up from the stomach (reflux), due to an incompetent valve at the base of the esophagus, can lead to Barrett’s disease, or changes in the lining of the esophagus.

Barrett’s is a precursor to esophageal cancer, the fastest-growing cancer diagnosis in the U.S., and it’s silent and painless at first.

Although survival rates are increasing due to awareness and early detection, an overwhelming number of those diagnosed— about 14,000 of the 17,000 annually— will die from this disease, usually due to late detection.

Symptoms of esophageal cancer include hoarseness, persistent cough, difficulty swallowing and unintended weight loss.

If you show one or more of these symptoms, talk to your doctor about screening. An upper endoscopy or a trans-nasal endoscopy performed in the office without sedation are two of the ways we can determine whether or not a patient has GERD, Barrett’s or esophageal cancer.

Treating acid reflux with medication has its own risks. In May 2010, the FDA published a warning suggesting a correlation between the ongoing use of these medications and bone fractures.

The suppression of natural acid by these medications may reduce your ability to absorb calcium and jeopardize bone density. The FDA recommends these medications not be used on an ongoing basis.

Unfortunately, many people find that they cannot live without daily use of these medications because the discomfort is unbearable. Medications often relieve feelings of heartburn, but they do not reduce your risk of esophageal cancer.

Acid reflux cannot be resolved without repairing the defective valve.

A patient with acid reflux may be a candidate for a procedure called TIF (trans-oral incisionless fundoplication), in which the defective valve is reshaped and strengthened. TIF is a noninvasive procedure performed in about an hour and without any incisions.

I have been performing TIF for nearly four years with great success. It’s exciting to see patients off risky medications and living comfortably without acid reflux. Most importantly, they are no longer putting themselves at risk for esophageal cancer.

Symptoms sometimes overlooked as being caused by acid reflux include chronic bad breath, post-nasal drip, regurgitation and sinusitis.

If you are concerned that you may have acid reflux and want to be sure your condition hasn’t progressed into Barrett’s disease, or if you want to know if you are a candidate for the TIF procedure, an initial consultation is the best place to start.

Gather the facts at the Esophageal Cancer Awareness Network at www.ecan.org and talk with your primary care doctor or a gastroenterologist.

Simoni is a board-certified gastroenterologist with a practice in Thousand Oaks.



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