Remote Link Between Heartburn, Cancer

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DEAR DR. DONOHUE: I have had heartburn for many years. I take Prilosec for it, and it works fine for me.

My doctor scheduled me for a gastroscope exam. I haven’t had one for quite a while. The doctor who did the scope called me and my family doctor to say that I had changes seen in the biopsy he took. He says I have Barrett’s esophagus, which can turn into cancer. Naturally, this has me worried.

Will you elaborate on Barrett’s esophagus and what I have to look forward to? Neither of my doctors has suggested a change in medicines. Do you? — T.M.

ANSWER: Barrett’s esophagus is a change in the kind of cells that line the lowermost part of the esophagus, the part that attaches to the stomach. That change brings with it a chance of further, cancer changes. The risk is quite small, about 0.5 percent per year.

Barrett’s esophagus happens to people who have GERD, gastroesophageal reflux disease, more popularly called heartburn. You take a medicine, Prilosec, that suppresses the production of stomach acid. Medicines that act similarly sometimes can retard the progression of these cell changes into cancer cells. They most definitely control heartburn. Barrett’s also can happen to people who do not have GERD.

The chance of cancer developing depends on a number of criteria. One is the kind of cells that have evolved. If they show low-grade changes, the likelihood of cancer is not as great as it would be if they show high-grade changes. The length of the area involved with these changes is another factor in determining the cancer risk.

You must not have had signs that raise the risk for cancer, or the doctor would have recommended immediate treatment. About the only thing you need to do is comply with the suggested follow-up scope exams so the doctor can see if any procedures are needed to eradicate these new cells. You don’t have to sit around and worry. You have not received a death sentence.

The booklet on GERD (heartburn) explains this common disorder and its treatments. Readers can obtain a copy by writing: Dr. Donohue — No. 501W, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Canada. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: At a recent cocktail party, a nurse admonished me for chewing ice. She said that it indicates an iron deficiency.

I get blood work done every six months. My doctor has never said anything about an iron deficiency or any other issue. I am 65 and in good health. — C.H.

ANSWER: The nurse was talking about pica. It’s a craving for materials not considered foods, like ice, clay, starch and dirt, to mention a few. Sometimes it is an indication of iron deficiency, but far from always.

In someone like you, who has lab tests done twice a year, you’re not anemic and don’t have pica.

You do, however, have a habit that will ruin your teeth if you don’t stop. Chewing on ice can cause microscopic fractures in tooth enamel, which can become larger fractures.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.

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