Frequently Asked Questions About Heartburn and Reflux
5. What foods should a person avoid if he or she has heartburn, GERD, or Barrett's esophagus?
What's on your plate can impact heartburn, GERD, and Barrett's esophagus. Eating certain foods, including onions, peppermint, and high-fat foods, as well as drinking alcohol, can cause the lower esophageal sphincter muscle, which controls the opening between the esophagus and the stomach, to relax. Usually, this muscle remains tightly closed except when food is swallowed. However, when this muscle fails to close, the acid-containing contents of the stomach can travel back up into the esophagus, producing a burning sensation commonly referred to as heartburn.
Caffeinated beverages and foods (such as coffee, tea, colas, and chocolate) can also aggravate heartburn and gastroesophageal reflux disease (GERD). Tomatoes, citrus fruits, or juices also contribute additional acid that can irritate the esophagus.
In addition, smoking relaxes the lower esophageal sphincter, contributing to heartburn and GERD.
Improving your eating habits can also reduce reflux. After eating, keep an upright posture. Eat moderate portions of food and smaller meals. Lastly, eat meals at least three to four hours before lying down, and avoid bedtime snacks.
6. What is Barrett's esophagus and how is it treated?
Barrett's esophagus is a change in the lining of the lower esophagus that develops in some people who have chronic GERD or inflammation of the esophagus.
The symptoms of Barrett's esophagus are the same as those of GERD, although often more severe. These symptoms include a burning sensation under the chest and acid regurgitation. These symptoms generally decrease with drugs that reduce acid in the stomach. Some people with Barrett's esophagus may not have any symptoms at all.
The only way to confirm the diagnosis of Barrett's esophagus is with a test called an upper endoscopy. This involves inserting a small, lighted tube (endoscope) through the throat and into the esophagus to look for a change in the lining of the esophagus. While the appearance of the esophagus may suggest Barrett's esophagus, the diagnosis can only be confirmed with small samples of tissue (biopsy) obtained through the endoscope.
The treatment of Barrett's esophagus is similar to the treatment of reflux. This includes lifestyle changes, such as avoiding certain foods and eating late in the evening, smoking cessation, and wearing loose-fitting clothing, along with using medications that will decrease acid production by the stomach.
Patients with Barrett's esophagus typically need PPI drugs to reduce acid.
Barrett's esophagus may lead to the development of cancer of the esophagus in some patients, although this risk is smaller than once thought. Up to 0.5% of those with Barrett's esophagus will develop esophageal cancer each year.
Esophageal cancer develops through a sequence of changes in the cells of the esophagus known as dysplasia. Dysplasia can only be detected by a biopsy. Patients with Barrett's esophagus should talk to their doctors about having regular screening exams to detect cancer at an early and potentially curable stage.