‘If you experience difficulty swallowing…’: Gastroenterologist cautions chronic heartburn could increase the risk of oesophageal cancer

Dr Sethi also shared a few ways to manage occasional heartburn, saying, “For occasional heartburn, try sleeping on your left side, eating dinner at least three to four hours before bed and consuming unsweetened fennel seeds after meals. You could also try some over-the-counter anti-acid medications.” However, he cautioned that it’s best to seek medical advice if symptoms persist, “especially if you experience difficulty swallowing or a sensation of food getting stuck in your foodpipe.”

So how can one distinguish between normal, occasional heartburn and chronic acid reflux that may require medical evaluation?

Dr Adithya V. Naragund, Senior Consultant in GI & HPB Surgery at Cytecare Hospitals, Bengaluru, tells indianexpress.com, “Occasional heartburn after a heavy or spicy meal is quite common and usually settles with simple measures such as avoiding triggers, eating smaller portions, or staying upright after meals. However, if heartburn occurs more than twice a week, persists despite lifestyle adjustments, or is accompanied by symptoms such as regurgitation, throat discomfort, chronic cough, or a sensation of food sticking in the chest, it could indicate gastroesophageal reflux disease (GERD).” 

He adds that persistent reflux should not be ignored, as it can lead to oesophageal inflammation over time. A gastroenterologist can confirm the diagnosis through tests such as endoscopy or pH monitoring and guide appropriate treatment.

On precancerous changes such as Barrett’s oesophagus

When acid repeatedly refluxes into the oesophagus, Dr Naragund informs,  it damages the delicate inner lining. Over time, the body tries to protect itself by replacing the normal squamous cells of the oesophagus with cells similar to those found in the intestine. This change, called Barrett’s oesophagus, is considered precancerous because it increases the risk of developing oesophageal adenocarcinoma. 

“Most patients do not notice new or distinct symptoms at this stage, which makes regular monitoring crucial for those with long-standing reflux. Worsening swallowing difficulty, unexplained weight loss, or persistent chest pain should prompt immediate medical evaluation,” states Dr Naragund. 

Long-term strategies or medical treatments that can help prevent chronic reflux from escalating into a more serious condition

In addition to lifestyle measures such as maintaining a healthy weight, avoiding lying down within three hours of eating, and limiting caffeine and alcohol, long-term management may involve medications that reduce acid production. 

“Proton pump inhibitors (PPIs) are commonly prescribed and highly effective in allowing the oesophagus to heal. For patients who do not respond adequately to medication or who wish to avoid lifelong dependence on drugs, minimally invasive surgical procedures such as fundoplication can help strengthen the valve between the stomach and oesophagus. Regular follow-ups are essential for individuals with chronic reflux to assess healing and detect early complications,” concludes the expert. 

DISCLAIMER: This article is based on information from the public domain and/or the experts we spoke to. Always consult your health practitioner before starting any routine.

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