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The Effects of Obesity on the Esophagus

Obesity is a leading factor in the worsening of acid reflux – the backwards movement of stomach acid into the esophagus. This is often due to a mechanical factor – the pressure of fat tissue on the stomach physically compressing the stomach and pushing its contents upward.  Acid reflux and its chronic form, gastroesophageal reflux disease or GERD, can range from mild to severe. Further, patients do not always experience significant symptoms, even if their reflux is significant – this is known as silent reflux. Over time, the constant barrage of stomach acid hitting the sensitive lining of the esophagus, if left untreated, can cause significant damage.

Acid reflux can also be caused by a hiatal hernia – when the upper portion of the stomach pushes through a hole in the diaphragm. This is commonly found and repaired in bariatric surgery patients.

Acid reflux can cause significant lifestyle issues. Other than the burning or painful discomfort of acid hitting sensitive esophageal lining, constant acidic movement can cause painful ulcers and narrowing of the esophagus, leading to difficulty swallowing. Most importantly, obesity and resultant GERD is a primary risk factor for changes in esophageal cells that can lead to cancer.

What Is Barret’s Esophagus?

When acidic damage to the esophagus continues unabated, there is the possibility of changes in the esophageal lining at a cellular level. This is called Barrett’s Esophagus and represents a significant phase in the progression of GERD toward cancer. The cellular changes that are seen when a patient develops Barrett’s Esophagus can present an increased risk of esophageal cancer. For that reason, it is very important that patients are aware of their acid reflux and take the steps necessary to mitigate it.

How Is Barrett’s Esophagus Diagnosed?

It is estimated that about 10% of people who have poorly controlled or chronic GERD develop Barrett’s esophagus. However, it is very important for patients who have any sort of chronic gastroesophageal reflux to be screened for cellular changes. These screenings can be performed by an ear nose and throat (ENT) specialist or a gastroenterologist. By performing an upper endoscopy, essentially putting a small camera into your throat, the doctor can see if Barrett’s esophagus is present. To confirm the diagnosis, a biopsy will be necessary.

Even though GERD may seem like a minor inconvenience, it is important that the symptoms are not allowed to continue over the long term. Both minor physical damage and serious issues, such as Barrett’s esophagus, can lead to significant problems in the future. A consultation with a qualified specialist is the best way learn more about what can be done to avoid or eliminate GERD at its root cause.

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