The burning question
When automotive journalist Markus Stier was in his 20s, he started experiencing burning pain in his chest about twice a month. For years, he suffered without seeking medical assistance. A girlfriend who worked in a pharmacy recommended antacids, and although they helped somewhat, Stier was initially doubtful that she’d pinpointed his problem.
“She suspected it was the stomach, which sounded weird to me, because the pain always came from a higher-located area,” says Stier, now 51. “Sometimes the cramps were so extreme that I had the feeling my chest would implode.”
About 15 years ago, Stier finally saw a doctor. He had accepted the idea that his pain might be stomach-related, so he was surprised to be diagnosed with gastroesophageal reflux disease (GORD), or inflammation of the oesophagus, the tube that leads from the mouth to the stomach.
“I still have the doctor’s words in my head: ‘Your stomach is totally fine inside, but the lower part of your oesophagus looks like flames climbing up the wall,’” Stier says.
His doctor prescribed medicine, which helped soothe his oesophageal inflammation. At the same time, Stier modified his diet, eliminating chocolate, sweets, spirits, juices and coffee.
A common problem
For many, the searing pain of heartburn is an unpleasant occasional fact of life. It’s often the sign of acid reflux: stomach acid backing up into the oesophagus when the muscle that’s supposed to separate the oesophagus and stomach doesn’t stay shut.
Heartburn tends to fade after a few hours, so many people don’t consider it a serious concern.
“It’s pretty acceptable to have once-a-month episodes of heartburn, particularly related to a heavy meal or alcohol,” says GI professor Daniel Sifrim. “It’s considered a disease when the symptoms are more than once a week, when it affects quality of life, or when there are complications.”
More frequent heartburn could indicate GORD, which sometimes causes damage to the delicate lining of the oesophagus due to the effects of stomach acid repeatedly spewing upward. Some people feel such intense pain, they worry that they’re having a heart attack.
“People say: ‘I woke up in the middle of the night with the most searing chest pain, and I rushed to the hospital thinking it was a heart attack, and they did all the tests, and they were normal,’” says professor of gastroenterology, Laurence Lovat. “They said maybe it was acid reflux.”
Complications may arise
Although GORD isn’t as serious as a heart attack, it isn’t always benign, either. Left untreated, GORD may cause complications over time. Some people get a chronic cough. Others may experience a narrowing of the oesophagus caused by scar tissue, which makes it difficult to swallow food comfortably. Years of damage may cause Barrett’s oesophagus, a condition that sometimes precedes oesophageal cancer.
“In one in ten people with chronic acid reflux, the lining of the oesophagus changes from being normal to being that of Barrett’s oesophagus,” Lovat says. “Barrett’s oesophagus itself has a one in ten or less chance of becoming cancerous. If you don’t have Barrett’s oesophagus, the likelihood of getting oesophageal cancer is almost zero.”