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Obesity and acid reflux linked to the development of esophageal cancer.

According to Mark B. Orringer, M.D. professor and head of thoracic surgery at the University of Michigan Health System, there has been a dramatic change in the type of patient developing esophageal cancer. Twenty years ago, esophageal cancer was primarily squamous cell carcinoma, found in people who drank alcohol and smoked excessively. As the obesity rate has climbed, however, Orringer has documented a 350 percent increase of adenocarcinoma (cancer that tends to be malignant) over the last 30 years. This is related to more gastroesophageal relux / reflux disease and Barrett's esophagus.

Reflux disease is an inflammation of the lower part of the esophagus, and causes heartburn and pain in the area below the breastbone. It happens as a result of the acidic contents of the stomach flow backwards and up into the esophagus. This back flow of acid is called reflux, or gastroesophageal reflux. One of the causes of reflux is being overweight.

Chronic and/or untreated acid reflux leads to a condition called Barrett's esophagus. Barrett's is a condition in which the cells lining the lower esophagus change because of repeated exposure to stomach acid. Normally, the tissue lining the esophagus is similar to the lining in your mouth (squamous mucosa), but with Barrett's, the body replaces the normal esophageal lining with one similar to that found in the intestines.

Esophageal cancer tends to be a "silent cancer" in that it's symptoms are mistaken for other conditions and/or ignored. As a result, it carries a terrible prognosis. By increasing awareness that heartburn may have serious implications, along with earlier detection, improved staging tests and better treatment are leading to better outcomes.

Five tips for preventing Barrett's Esophagus and esophageal cancer

1).  Work on losing weight. Obesity leads to hiatus hernia and reflux which are in turn responsible for the increasing rates of esophageal cancer. Talk to your family physician about developing a plan to lose weight by eating well and exercising regularly.

2).  Don't lie down after eating. For those with acid reflux, the valve between the esophagus and the stomach doesn't function properly, allowing the contents of the stomach to back up into the esophagus. Lying down can make this problem worse, leading to late-night heartburn. Be sure to eat early to give your stomach time to empty before bedtime.

3).  Sleep propped up. Lying down can exacerbate acid reflux. If you have reflux, consider arranging pillows so that your head and upper chest are elevated while you sleep. Stomach acid, like water, does not roll uphill.

4)  Take an antacid. Neutralize stomach acid before it backs up into the esophagus with antacids.

5).  Talk to your doctor. If you have a long history of severe heartburn or acid indigestion, talk to your doctor about Barrett's esophagus, which increases your risk of developing cancer. Even if your acid reflux symptoms are controlled, you still could be at risk. The only way to diagnose Barrett's is with an endoscopy and biopsy. Esophageal cancer can be cured, if it is diagnosed early

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