Gastroesophageal reflux disease is a common upper gastrointestinal problem in Taiwan and about 2 percent of patients develop Barrett’s esophagus, increasing their risk of esophageal cancer, a physician said yesterday.
The prevalence of gastroesophageal reflux disease in the nation is about 20 percent to 30 percent and is growing, Taipei City Hospital Heping Fuyou Branch family medicine physician Chiu Lin Shao-chia (邱林劭嘉) said.
The disease can be categorized into two types according to the symptoms: The main “typical” symptoms are heartburn and regurgitation — the involuntary return of undigested or partially digested food or fluids from the stomach into the mouth in a less forceful manner than vomiting, she said.
The “atypical” symptoms include noncardiac chest pain, difficulty swallowing, an abnormal sensation in the throat, nausea and extra-esophageal symptoms, such as chronic cough, asthma and laryngitis — inflammation of the vocal cords, she added.
Barrett’s esophagus is a complication of gastroesophageal reflux disease marked by an abnormality in the lining of the lower esophagus, Chiu Lin said, adding that it increases the risk of developing esophageal cancer.
Having gastroesophageal reflux disease for at least five to 10 years is a required condition for developing Barret’s esophagus, while other risk factors include hiatal hernias, in which abdominal organs slip through the diaphragm into the middle compartment of the chest; obesity; smoking tobacco; and increased reflux symptoms at night, she said.
As many people can exhibit symptoms of gastroesophageal reflux disease for a long time, there are some signs that people should be aware of that require immediate medical attention and an endoscopic examination, Chiu Lin said.
The signs include new indigestion problems in people older than 60; gastrointestinal bleeding, as evidenced by spitting blood, bloody stool and a positive fecal occult blood test; unexplained weight loss; difficulty swallowing; pain when swallowing; and chronic vomiting, she said.
People whose first-degree relatives have a history of gastrointestinal cancer, those with many Barrett’s esophagus risk factors and individuals who demonstrate poor drug response are also at high risk, she added.
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