LifeCare Chiropractic

The Best Chiropractic Care in Mesa, Arizona

Barrett's esophagus

Reflux Disease, Barrett’s Esophagus and Esophageal Cancer: Critical Detail

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Patients who have reflux are almost exclusively given ulcer drugs with the rationale to block the development of cancer of the esophagus.

The thinking is that is you can block the constant irritation of acid on the lining of the esophagus, which was not designed for high levels of acidity, you can stop the progression to neoplasia (neoplasia = precancerous cells).  Neoplasia can occur with any tissue that is under constant attack and repair.  The more a tissue has to replace damaged cells with new ones, the more likely an error in cell division is to occur.  Errors can lead to cancer.

At the surface, the idea of blocking acid may seem like a good idea.  At least it does until you factor in that in no way does this treatment approach address the reason the reflux is present in the first place.  Then, when you factor in the fact that stomach acid is just kind of important in say, EVERYTHING, as this approach begins to sounds like a disaster waiting to happen.

Deep down inside the drug companies are probably aware of this.  That’s why every SINGLE drug designed to block stomach acid production clearly states that it is for short-term use only.  Usually no longer than 3 months.

And yet patients are put on these drugs for years and years and years and the devastation to health is virtual incalculable.

Our bodies digest.  And then our bodies do everything else.  Without an intact digestive system optimal health can NOT be achieved.  And ulcer drugs absolutely destroy your body’s ability to digest.

As I’ve said consistently in previous articles, if you’ve got a bleeding ulcer (which most likely came from taking aspirin or ibuprofen…) it is not the time to worry about long-term effects of blocking acid.  These drugs can be life-saving if you have a bleeding ulcer.

Any other time, however, they are one of the worst things you can take long-term.

The real answer to the problem lies in figuring out where the reflux is coming from.  Food allergies (like gluten, dairy, corn, soy), abdominal obesity, tight belts and stress can all play a role in reflux.  While fixing some of these can be long-term solutions, digestive enzymes can frequently work miracles in the short-term.

But what about the risk of developing cancer of the esophagus?

Turns out that acid-blocking drugs do little about the progression from Barrett’s esophagus (a pre-cancerous condition of the esophagus).  Rather, the answer is far more complex.  Things like nitrates in your food choices (which you can read about in a previous article by clicking here) will affect risk.

This particular study gives us even more information about factors that will greatly affect your risk of developing cancer of the esophagus.

In it, researchers looked at the relationship between physiology’s arch enemy, inflammation, and the development of esophageal cancer.  Specifically, they looked at several markers in a small group of 397 people diagnosed with Barrett’s esophagus:

  1. C-reactive protein (CRP)
  2. Interleukin-6 (IL6)
  3. Soluble tumor necrosis factor (sTNF) receptors I and II
  4. F2-isoprostanes (a marker of oxidative stress)

They looked at several other lifestyle factors as well.  Here’s what they found:

  • Those with higher CRP levels had an 80% higher risk of esophageal adenocarcinoma.
  • Even worse, those with higher CRP and an elevated waist–hip ratio had a 198% higher risk.
  • Higher CRP and smoking upped risk 177%.
  • Higher IL6 levels had a 200% higher risk of esophageal cancer.
  • Elevated waist-to-hip ratios and smokers did not have a further risk above IL-6.

When you look at these numbers, pay attention to the fact that inflammation is NOT reduced by the use of acid-blocking drugs.  In many cases, the use of these drugs to block normal digestion would increase inflammation.

Another important thing to note is that having an elevated waist-to-hip ratio (meaning these people were very likely pre-diabetic) was more dangerous than cigarette smoking.

Got that?  More dangerous than cigarette smoking.  Everyone knows that smoking is bad for you, but very, very few people truly understand the devastation that pre-diabetes wreaks on your long-term health.

If the 2/3 of society (by my estimation) that are pre-diabetic understood these risks better, maybe we’d pay a little better attention to our lifestyle choices.

The last comment I have to throw out this is that drugs that block acid production are well-known to negatively affect bone health.  Poor bone health leads to an increased risk of diabetes (in case you were not aware of this relationship, you can read about it in a previous article by clicking here).

Following this line of thinking, it may very well be that the treatments we THINK are protecting the esophagus are actually increasing the risk of the esophageal cancer we are trying to stop.

Heartburn or Prediabetes, Which Leads to Esophageal Cancer?

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There are times when it seems like every other patient coming into my office is on some type of acid blocker drug to treat their ulcer or heartburn.  Most have the mistaken belief that they make too much stomach acid.  Consider this: stress lowers stomach acid production and stomach acid production drops as we get older.  With these two factors alone, do you think there is anyone who makes too MUCH stomach acid these days?

The easy answer is no.  However, if someone has a bleeding ulcer, blocking the acid production will likely save his or her life.  Every other case is likely to do much more harm than good.  The list of problems associated with acid blocking drugs is quite long.  This should come as no surprise given that stomach acid is absolutely essential for a large number of critical processes in the human body (digestion, activation of other enzymes, sterilization of bacteria, activation of the pancreas, absorption of certain nutrients, activation of anti-cancer compounds, etc…).

The list includes:

The recommendation for acid blocker drugs in many times goes beyond symptom relief and more into the mistaken belief that acid blocking drugs will prevent the progression to Barrett’s esophagus and then to esophageal cancer.  As you can see from the study above, the opposite is true.  These drugs may actually increase the risk for the condition many doctors are trying to prevent.

This particular article adds weight to this, suggesting that prediabetes is as great of a risk factor, if not greater, for the development of Barrett’s esophagus than is reflux.  In some cases quadrupling the risk.  This means that the approach to managing any type of gastric issue, whether reflux, ulcer or gastritis needs to involve the whole spectrum of lifestyle changes to head the patient away from diabetes.  Shocking to hear me say this, but true.

The other thing to consider is that, most often, patients with heartburn actually make too LITTLE stomach acid.  Supporting digestion, using probiotics and improving the diet can go av very long way towards getting rid of reflux for good.