Most of the questions I receive are from RefluxMD members who have Stage 3 or Stage 4 reflux disease. However, many more adults are suffering from Stage 1 reflux disease today, and most of them are unaware of the message their body is sending them. I recently received a question from a man in his 50’s who had been having GERD symptoms several times a week for over a year. Although he had seen his family physician, he was still concerned about his symptoms and asked what I would recommend. If you or someone you know has been taking any anti-reflux medication for over a year, I highly recommend that you read this article and share it with others.
I am worried about my reflux symptoms and assessment. Although I lead a healthy lifestyle (I am a marathon runner, I’m not overweight, I eat six small meals a day, and I practice relaxation techniques), I have had increased symptoms over the last year. I am not presently taking PPI’s but did last summer with good results. I talked to my GP about my concerns including whether I was at risk for esophageal cancer and she was not worried and did not recommend follow up other then take an H2 blocker when needed. I am not sure how to proceed. What should I do?
Thank you for asking your question! As a young, healthy person who would like to maintain your overall healthy lifestyle, it makes sense that you would be concerned about your symptoms. We understand that! Since you mentioned concern about esophageal cancer, let’s talk about your diagnosis, your cancer risk, and your options.
Is your GERD diagnosis correct?
It certainly “sounds” like you have reflux-related symptoms based on your comments and the fact that you seem to respond to acid-suppressing medications. However, believe it or not, if a physician advises you using only those facts, there is about a 30% chance that the diagnosis of GERD will be incorrect. Unfortunately, many physicians today make this diagnosis without adequate diagnostic testing and they recommend the wrong treatment plan to their patients. We want you to take medications long-term only if you have a disease or a problem that warrants their use.
The risk of esophageal cancer
Many belittle the risk of esophageal cancer caused by GERD. Although it is somewhat rare, we can identify a pre-cancerous condition called Barrett’s esophagus by endoscopy. Risk factors for developing Barrett’s esophagus include:
- Male gender,
- Smoking, and age
- Over age 50.
Determining who should be screened for Barrett’s is a very controversial subject today; however, you do have two risk factors.
Your symptoms and my suggestion
Let’s recap your situation:
- Your symptoms have been present for more than a year,
- You have symptoms several times weekly,
- Your are concerned about esophageal cancer, and
- You have two risk factors for Barrett’s esophagus
Based on those factors, I would recommend that you consider seeing a GERD expert and scheduling an endoscopy to look for the presence of Barrett’s esophagus and a pH study to confirm the diagnosis of GERD.
Remember, medical studies look at large groups of patients to arrive at general recommendations, but you are one patient with specific issues who must be treated as an individual. An endoscopy to rule out Barrett’s, as well as a pH study to confirm the presence of GERD will allow you to move forward with the information you need to treat your reflux – once it is proven you do have GERD.
I strongly encourage anyone concerned about GERD symptoms schedule an appointment with a GERD expert.