Many adults either ignore their acid reflux symptoms or simply treat them with daily medications, allowing for the potential of disease progression. Although complications such as Barrett’s esophagus and esophageal cancer only impact a small percentage of GERD patients, many more people experience a serious deterioration in their quality of life as they age. For those with Barrett’s esophagus or advanced GERD, there are solutions available.

Your question:

I have been diagnosed with Barrett’s Esophagus from an EGD with biopsies. I am really looking for a cure for my burning and coughing and breathing – my whole quality of life has been consumed with GERD and Barrett’s. I really want a cure…

RefluxMD response:

Thank you for your question, and I am sorry to learn that your GERD has progressed to Barrett’s esophagus, a pre-cancerous condition. Both GERD and Barrett’s esophagus can have a very significant impact upon one’s quality of life, as you report. That is why RefluxMD has been so aggressive in raising awareness of the symptoms of GERD, hoping that during the early stages most sufferers will make the necessary body weight, diet, and lifestyle changes to avoid this kind of suffering later in life.

Barrett’s esophagus and GERD

For those not familiar with Barrett’s esophagus, this condition is typically associated with GERD, resulting from the constant flow of stomach acid regurgitating up and into the esophagus. For some people, this exposure to stomach contents causes the cells in the esophagus to change into tissue that is similar to the lining of the intestines. If unchecked, further progression could result in low-grade dysplasia, followed by high-grade dysplasia, and finally adenocarcinoma, or esophageal cancer. However, according to the NIH, the risk of progressing from Barrett’s esophagus to esophageal cancer is about 0.5% per year. Unfortunately, the incidence of this condition has increased over the last 20 years, and according to the NIH, researchers estimate that between 1.6% and 6.8% of adults have Barrett’s esophagus today. Many more of them are unaware because they are asymptomatic.

Does daily use of PPIs prevent Barrett’s esophagus?

Although there is controversy about the underlying cause of Barrett’s esosphagus, RefluxMD’s medical advisors believe that it is a complication resulting from GERD in most cases. They believe that stomach acid, pepsin, and/or bile, all coming from the stomach into the esophagus, can play a role in the transition of the esophageal cells to Barrett’s cells. Thus, even if PPIs effectively reduce the acidic level of the stomach, bile and pepsin can still reach the esophagus, potentially resulting in cellular change. Dr. Tom DeMeester stated in his Huffington Post article that a good response to PPI medication does not eliminate the risk of cancer: “According to a study by Dr. Blair Jobe at the University of Pittsburg, PPI-treated GERD patients, who have mild or absent symptoms while on the medication, were 60 percent more likely to have Barrett’s esophagus, a precancerous condition, than those with more severe symptoms while on the medication.”

Likewise, Dr. Chandrasoma believes that PPIs can not prevent Barrett’s, as he stataed in his article, Common questions about Barrett’s esophagus: “Many GI docs treat patients who do not have GERD symptoms with PPIs because they believe that PPIs have a positive effect on Barrett’s. Some believe that PPIs reduce the risk of progression of Barrett’s to cancer. There is no evidence to support either of these viewpoints. Patients with asymptomatic Barrett’s should not be treated with PPIs. The only things PPIs are proven to do is control erosive esophagitis and control heartburn, so they aren’t necessary when neither of these is present.”

What can be done to treat Barrett’s esophagus and GERD?

The status quo treatment today, as described by the Mayo Clinic, is increased monitoring via endoscopy and biopsy to detect progression to dysplasia, along with traditional GERD treatments that includes weight management, diet, lifestyle changes, and medications to manage GERD symptoms. However, as we have highlighted in many of our personal member stories, surgery to restore the LES can be a very effective treatment option and should also be considered by anyone experiencing deterioration in their quality of life.

For example, we shared the story of Howard in an articles titled, Endoscopy uncovers Barrett’s esophagus after years of PPIs. Howard, an avid bike rider who rode 200+ miles weekly, was in good shape, had a low BMI, and was a non-smoker. Except for irregular episodes of heartburn which started early in life, he wasn’t concerned until his symptoms became more frequent and severe. Diagnostic testing revealed esophagitis and Barrett’s esophagus. Howard made the decision to research this condition and to evaluate all possible treatment options. He decided on radiofrequency ablation treatment for his Barrett’s esophagus and a TIF antireflux surgical procedure for his GERD. His symptoms are gone and his quality of life is once again very good.

RF ablation for Barrett’s esophagus

Dr. Dengler first wrote about radiofrequency ablation to treat Barrett’s esophagus (RF ablation for Barrett’s esophagus) in 2013 and later that year Dr. Chandrasoma also discussed this procedure in an article titled, A closer look at RF ablation. Since then we have seen many doctors and medical centers adopt this procedure, including Massachusetts General Hospital, Cleveland Clinic, and Houston Methodist. There is a listing of physicians that perform RF ablation at the Covidien Company’s website using the online Physician Finder. Some insurance companies may limit coverage for this procedure to those patients with low or high-grade dysplasia, however we are aware of patients with Barrett’s esophagus, like Howard, that were approved for RF ablation.

So you want a cure – there are alternatives to discuss with your specialist

I hope this helps! As you can see, there are several treatment options to discuss with a specialist. However, we highly recommend that you identify a GERD expert since all of these procedural options are very advanced, and we believe that the potential for improved results is better with a highly experienced expert.

This article was written by Bruce Kaechele, founder of RefluxMD. He is a non-medical GERD expert, having been trained by world-class GERD-specialists, including Dr. Tom DeMeester and Dr. Para Chandrasoma. Mr. Kaechele has written over 300 articles on acid reflux, two books on GERD-friendly diets, and he has directly coached several thousand GERD sufferers to find their path to relief and good health.