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Dr. Dennis Wilcox

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"How a common health problem is quietly becoming an unsuspected killer"
By TARA PARKER-POPE

Staff Reporter of
THE WALL STREET JOURNAL
October 10, 2005

Heartburn, Gerd and Cancer Risk

THE FACTS ABOUT HEARTBURN, REFLUX DISEASE AND CANCER

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FACT: HEARTBURN CAUSES CANCER

Frequent heartburn is associated with a serious disease we call GERD (Gastroesophageal reflux disease). This disease if inadequately treated produces cellular damage, mutations and cancer.

GERD AND CANCER RISK

What is the risk of developing esophageal cancer from reflux disease?  In the last twenty years the incidence of this cancer has increased faster than any other malignancy. Many experts agree that it is no accident that this has happened since the advent of strong acid suppression drugs. More people are taking more of these drugs and more people are turning up with cancer. Despite this phenomenon the pharmaceutical industry has continued to produce more and stronger acid lowering medications.

Scientists in the research of the esophagus have discovered that the longer a patient with GERD has the disease and takes these medications the more likely he is to get cancer. This fact was demonstrated in a study published in the New England Journal of Medicine.   We now recognize that acid is not the chemical that causes cancer of the esophagus. This is the reason why acid-lowering medications may make you feel better but may not protect you from the complications of the disease, even cancer.

BILE REFLUX AND ESOPHAGEAL CANCER

Bile, which is produced in the liver and mixed with secretions of the pancreas refluxes from the duodenum into the stomach in most people. Stomach acid buffers the bile, which is highly alkaline. This buffering action of normal stomach acid protects the stomach lining. If one has reflux of stomach juice into the esophagus (GERD) then acid in this setting can actually protect the stomach lining from the bile. When one suppresses the stomach acid with medication the bile that reaches the esophagus can cause damage (esophagitis) and even mutations (Barrett’s metaplasia). About 20% of GERD patients carefully biopsied with endoscopy have a pre-malignant condition we call Barrett’s esophagus. These patients, it is estimated, will develop cancer at the same rate as smokers who smoke a pack a day for twenty years. Most people do not smoke because they wish to avoid cancer but they will take their anti-reflux medications without realizing that they too are at risk.

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