Is there a connection between chronic heartburn and esophageal cancer?

You've always had a bit of what is considered a sensitive stomach. You avoid spicy foods, keep antacids in your bag or take an over-the-counter acid reducer when heartburn flares up.

Occasional heartburn, or acid reflux, is common and usually isn't a cause for concern. Millions of Americans experience heartburn at least once a month. But chronic heartburn is different.

Persistent reflux is worth paying attention to because it can lead to changes that go unnoticed until they've progressed. Knowing when heartburn is more than an occasional annoyance can help you get the right treatment before complications develop.

Let's take a look at chronic heartburn and its potential impact on your health. 

Understanding chronic heartburn and GERD

Heartburn happens when stomach acid flows backward into your esophagus, the tube that carries food from your mouth to your stomach. Normally, a ring of muscle at the bottom of the esophagus keeps stomach contents where they belong. When that muscle weakens or relaxes at the wrong time, acid can escape upward and cause a burning sensation in your chest.

When this happens frequently, becoming chronic heartburn, it's often a sign of gastroesophageal reflux disease (GERD), one of the most common digestive conditions that can damage the lining of your esophagus over time.

Other symptoms of GERD may include:

• Heartburn that has become a regular part of your week, rather than an occasional occurrence.
• Reflux symptoms that wake you up at night or make it difficult to get restful sleep.
• Reflux that interferes with meals, exercise or other everyday activities.
• Trouble swallowing or a feeling like food gets stuck on the way down.
• Chest discomfort, wheezing or shortness of breath.
• A lingering dry cough or a frequent need to clear your throat without another obvious cause.

You may be trying to manage these symptoms on your own. Over-the-counter medications can provide quick relief, and it's easy to assume the problem has been solved – until it returns again. But symptom relief isn't always the same as preventing damage or diagnosing a more serious condition such as esophageal cancer. 

Can chronic heartburn cause esophageal cancer?

So, can chronic heartburn cause esophageal cancer? The answer is yes, in some cases.

Most people with chronic heartburn will never progress to the point that they develop esophageal cancer. And heartburn itself doesn't cause cancer. Instead, years of repeated acid exposure from GERD can irritate or injure the cells lining the esophagus. For some people, those cells gradually change into a different type that is more resistant to stomach acid, a condition known as Barrett's esophagus.

Barrett's esophagus isn't cancer, but those abnormal cells have a greater chance of becoming cancerous over time. It’s for this reason that Barrett's esophagus is considered a precancerous condition and needs ongoing monitoring and, in some cases, laser ablation treatment.

That is why healthcare providers encourage people living with long-standing GERD to discuss their symptoms and be sure they are seeing their primary care provider regularly, rather than simply treating them indefinitely with over-the-counter medication.

What increases your risk of esophageal cancer?

According to the American Cancer Society, over 22,000 people in the United States will be newly diagnosed with esophageal cancer annually, with roughly 16,000 deaths annually. Although esophageal cancer is uncommon compared with many other cancers, it is often diagnosed after symptoms develop.

Finding Barrett's esophagus before cancer develops offers an opportunity to monitor changes and, when needed, treat them early.

Several factors can increase the risk of esophageal cancer, including:

• Tobacco use
• Heavy alcohol use
• Obesity
• Older age
• Family history

Recognizing ongoing symptoms could indicate your chronic heartburn may be something more and gives your healthcare provider the opportunity to determine whether additional testing is appropriate.
 

Related: Sam’s story: How this man’s heartburn led to cancer

4 ways to help relieve chronic heartburn

If you experience chronic heartburn on a regular basis, small changes to your daily routine can often make a difference. While these steps may help reduce symptoms, they aren't a substitute for seeing your healthcare provider if heartburn keeps coming back or requires frequent medication.

1. Identify and avoid your heartburn trigger foods

Not everyone has the same triggers, but common culprits of heartburn include:

• Spicy foods
• Fried or fatty meals
• Tomato-based foods
• Citrus
• Chocolate
• Peppermint
• Caffeine
• Alcohol

Keeping a food diary for a few weeks can help you spot patterns and identify the foods most likely to trigger your symptoms.

2. Eat smaller meals and avoid eating late

Large meals put more pressure on your stomach, making it easier for acid to flow back into the esophagus. Try eating smaller portions throughout the day and finish your last meal at least three hours before lying down or going to bed.

3. Maintain a healthy weight

Carrying extra weight, particularly around your abdomen, can increase pressure on your stomach and contribute to reflux. Even modest weight loss can improve GERD symptoms.

4. Make a few changes at bedtime

If you often experience heartburn at night, try raising the head of your bed by six to eight inches using bed risers or a wedge pillow. Sleeping with your upper body elevated can help keep stomach acid where it belongs.

Protect your esophagus by taking chronic heartburn seriously

If you have become used to living with heartburn, you may not think twice about treating it yourself. While most cases of heartburn aren't a sign of a serious condition, some symptoms shouldn't be ignored because they may indicate that something more than routine acid reflux is going on. 

Make an appointment with your healthcare provider if you notice any of the following:

• Over-the-counter heartburn medications provide little or no relief.
• Swallowing becomes difficult.
• You're losing weight without trying.
• You develop recurring fevers along with your symptoms.
• Your stools appear black or tarry, which can be a sign of bleeding in the digestive tract.

Incorporating healthy lifestyle changes or other therapies can relieve symptoms of chronic heartburn or GERD while helping prevent long-term damage to your esophagus. And if Barrett's esophagus is found, regular monitoring allows your doctor to watch for changes and potentially treat them before they become more serious.

Heartburn may be common, but living with chronic heartburn week after week doesn't have to be.

Time to see a gastroenterologist for chronic heartburn? Take our digestive quiz and find out.