Acid Reflux

Gastroenterologist Dr. Yazan Abu Qwaider discusses acid reflux.


What is acid reflux?

Acid reflux is a condition like gastroesophageal reflux disease (GERD), which is the ejection of acid from the stomach into the esophagus. The stomach is an organ, and in medicine we call it low functional and highly protective, because it digests food and has a high acid content. The esophagus, on the other hand, is low protective and highly functional, so the lining of the esophagus doesn't have a lot of protection from acid ejection from the stomach. When the acid ejects from the stomach into the esophagus, it's what we call reflux.

What are the symptoms of acid reflux/GERD?

Gastrointestinal symptoms usually include the sensation of acid coming up. But reflux disease goes beyond that. Symptoms might include chronic sinus infection, chronic sore throat, chronic cough, recurrent ear infections, these are all symptoms related to organs outside of gastroenterology. So GERD has a wide variety of symptoms. I've seen patients with chronic headaches because of GERD.

What are the long-term effects of acid reflux/GERD?

Thirty million people in the United States suffer from reflux at least once a week. And reflux is also the number one risk factor for esophageal cancer (outside of family history). So if a patient has reflux disease for five or more years, it is recommended that he or she undergo an upper endoscopy to look at the lining of the esophagus. The lining of the esophagus can be replaced by lining that is highly protective because the esophagus is trying to protect itself. This lining puts patients at risk of esophageal cancer. It's called Barrett's esophagus, and it's a precancerous condition. Usually we find it in patients who suffered from reflux for five or more years. If we find Barrett's or a change in the lining, typically the recommendation is an upper endoscopy every two or three years. We'll go back and take random biopsies or samples, and we will look at them again. And the important factor here is controlling symptoms, because studies show that better control of reflux symptoms reduces the progression of Barrett's esophagus to esophageal cancer. My goal is to keep an eye on my patients who have changes in the lining or who have Barrett's esophagus, so I can help them control their symptoms. There are different medications that we can use to control the symptoms, but that depends on each individual patient.