What Causes Acid Reflux and GERD - Esophageal Disorders

In 22 years of studying patients with acid reflux disease and hiatus hernias, American surgeons J. Borne and L. Goldwater found that 4.5 per cent of them had a Barren's esophagus. They fell into two groups: children from birth to 15 years old, and adults from 48 to 80 years old. Three times as many men as women had it, and some families had more than one member with it.Barren's esophagus has been linked with cancer, but this is a subject of controversy. There have been repeated reports of people with both Barren's esophagus and esophageal cancer, the biggest series of reports being from the Mayo Clinic in the USA. There, Dr A. J. Cameron and colleagues found that 18 out of 122 people (15 per cent) with Barren's esophagus developed esophageal cancer.Although this sounds very high, when they followed up the remaining 104 patients, only 2 more of them developed cancer – a 2 per cent rate. This is difficult to explain. In another series by S. J. Spechler and colleagues, only 2 out of 105 patients with Barren's esophagus developed esophageal cancer over the next three years.Both were heavy smokers and drinkers who refused to stop their habits and did not take the doctors advice about acid reflux diets. Taking the two series together, the esophageal cancer rate was still 40 times that expected of people without any known esophageal disease, but the risk remained small for each individual.The risk is even lower when it is considered that, of the patients with Barren's esophagus in these studies, 85 per cent were cigarette smokers and 76 per cent were 'addicted to alcohol'. As these two habits are known to raise the risk of esophageal cancer, and may be instrumental in causing Barrett's esophagus in the first place, it is difficult to calculate the risk, if there is any, of cancer if you have Barren's esophagus, acid reflux or GERD, do not smoke and only drink a little. What the reports do make very clear is that if you have a Barren's esophagus and you are a smoker and heavy drinker, you must stop.