by Ann Marie Dwyer

Created on: December 14, 2008

Gastroesophageal reflux disease (GERD is a chronic condition whose primary symptom is heartburn which recurs at least twice per week. Left untreated, GERD can lead to more serious conditions, such as Barrett's esophagus and esophageal cancer, adenocarcinoma of the esophagus.

What is GERD?

GERD is caused when the sphincter at the end of the esophagus the fails to close properly after food passes into the stomach. Digestive acids from the stomach reflux, or rise back up, into the esophagus. The corrosion of the esophagus causes a burning sensation in the chest and throat.

GERD can cause a dry cough and difficulty in swallowing. It aggravates asthma symptoms and can often interrupt sleep. If untreated, GERD can damage the lining of the esophagus producing bleeding or ulcers.

Smoking can cause GERD symptoms to flare. Improper inhaling of the tobacco smoke can trigger the swallowing reflex which sends the smoke down the esophagus to the stomach. The sphincter misinterprets the density of the smoke and will not close properly after admitting the smoke into the stomach.

Certain foods and drinks are known to aggravate GERD, including: citrus fruits and juice, fried foods, chocolate, tomato-based foods and juice, spicy foods, alcohol and caffeinated beverages. The stomach over produces acid to digest these foods and drinks which increase the likelihood of reflux.

Excess weight and tightly fitted clothing increase intra-abdominal pressure which can push stomach contents against a weak sphincter triggering GERD symptoms. Reclining after eating also increases intra-abdominal pressure. Large meals both increase pressure and overstimulate the stomach acid producing glands.

What is Barrett's esophagus?

The lining of the esophagus becomes eroded when left in contact with stomach acid. Prolonged exposure to stomach acid causes the esophageal cells to change at the cellular level. The esophageal lining changes into an intestinal lining, in a process called intestinal metaplasia.

No symptoms can be attributed to Barrett's esophagus, although the GERD which leads to it produces heartburn. Barrett's esophagus is diagnosed with an endoscopy where the doctor will look for the appearance of Barrett tissue.

The doctor must take a biopsy to confirm a diagnosis of Barrett's esophagus and to check for dysplasia, the changing of normal cells into precancer cells. Barrett's esophagus is a risk factor for adenocarcinoma of the esophagus, a form of cancer. Nearly all adenocarcinoma patients have Barrett's

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