Does my severe heartburn indicate Barrett’s esophagus?

Question

Hello doctor,

I have had severe heartburn almost every day for two years, especially after eating or lying down. I wake up at 2 to 3 AM, choking on acid in my throat with a terrible, bitter taste. My voice is hoarse all the time, I have a constant dry cough, and sometimes food feels stuck in my chest when swallowing.

I have been taking Tums and Pepcid multiple times daily for months, but they only work for 30 minutes. The symptoms are ruining my sleep and making me miserable. My scope showed inflammation, erosions, and Barrett's esophagus.

What is Barrett's esophagus, and is it cancer?
Will I get esophageal cancer?
What if medications do not work?
What foods should I avoid, and should I stop coffee and alcohol?
Does losing weight help, and what about sleeping position?
Do I need surgery?
Can GERD be cured, and will this get worse?
How often do I need a scope to check for cancer?

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern, and let me explain it in a very simple way. Heartburn is the burning feeling in your chest or throat, and it happens when stomach acid goes back into the esophagus. When this happens again and again and starts damaging the food pipe, it is called gastroesophageal reflux disease (GERD).

Your symptoms, such as burning, cough, hoarseness, choking at night, and difficulty swallowing, are typical signs of gastroesophageal reflux disease (GERD). Barrett’s esophagus means the inner lining of your lower food pipe has changed due to long-term acid exposure. It is not cancer, but it is a warning condition. Only a small number of people with Barrett’s develop cancer, so it is not a cancer diagnosis.

Gastroesophageal reflux disease (GERD) happens when the valve between your food pipe and stomach becomes weak. This can be due to excess weight, certain foods like fatty or spicy food, caffeine, alcohol, smoking, some medications, eating large meals, or lying down soon after eating.

If not controlled, it can cause ulcers, narrowing of the food pipe, Barrett’s esophagus, and rarely cancer. Since you already have inflammation and Barrett’s, it is important to control acid reflux properly.

You should consult a gastroenterologist for proper evaluation, correct diagnosis, and to start the most suitable treatment plan based on your symptoms. I would recommend the following:

Tablet Omeprazole 40 milligram - take one tablet in the morning before breakfast.
Tablet Pantoprazole 10 milligram – take one tablet in the morning, evening, and night before meals.
Tablet Dicyclomine – take one tablet in the morning, evening, and night before meals.
Syrup Graviscon (antacid) - take one spoon in the morning and at night.
Antacids (Calcium carbonate, Aluminum hydroxide, Magnesium hydroxide) - work quickly by neutralizing acid but give short relief (30 to 60 minutes).
H2 blockers (Famotidine) - reduce acid production for a moderate duration (6 to 12 hours).
Proton pump inhibitors (Omeprazole, Esomeprazole, Pantoprazole) - most powerful, reduce acid for about 24 hours

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.