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Sharon Gillson

Why does persistent acid reflux sometimes lead to cancer?

By August 14, 2007

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In research recently published, scientists discovered that people with gastroesophageal reflux disease (GERD), particularly those with the GERD complication called Barrett’s esophagus, have altered cells in their esophagus containing shortened telomeres, the ending sequences in DNA strands. The findings of this research indicate that the shortened sequences may allow other cells more prone to cancer to take over.

According to Dr. Rhonda Souza, associate professor of internal medicaine that UT Southwestern, “The research supports why it is important to prevent reflux, because the more reflux you have and the longer you have it, the more it might predispose you to getting Barrett’s esophagus. So you want to suppress that reflux.”

When GERD is either goes untreated or isn't treated effectively, stomach acid can frequently reflux back up into the esophagus. When this happens, it can cause normal skin-like cells in the esophagus to change into tougher, more acid-resistant cells like those found in the stomach and intestine. When this happens, a patient is diagnosed with a a condition called Barrett’s esophagus.

Adenocarcinoma of the esophagus, the cancer that is especially associated with Barrett’s esophagus, is currently the most rapidly rising cancer in the U.S., with a sixfold increase in cases during the past 30 years, according to the National Cancer Institute.

Researchers compared telomere length and telomerase activity in biopsy specimens from 38 patients with GERD and 16 control patients. This new line of research suggests that the continuous acid reflux affecting esophageal cells causes them to divide more frequently in order to regenerate the damaged lining. However, each time the cells divide, the telomeres at the end of DNA become shorter. When they become too short, the aging cell can no longer divide, Dr. Souza said.

Scientists suspect that when cells can no longer divide, other cells might infiltrate the area to make up for the loss. And those cells may be more likely to generate the acid-resistance that makes them more likely to turn cancerous.

Related Resources:

Gastroesophageal Reflux Disease
Gastroesophageal reflux disease (GERD), also known as acid reflux disease, occurs when the lower esophageal sphincter (LES) does not close properly and stomach contents leak back, or reflux, into the esophagus.

Barrett's Esophagus
Barrett's esophagus is a condition in which the esophagus, the muscular tube that carries food and saliva from the mouth to the stomach, changes so that some of its lining is replaced by a type of tissue similar to that normally found in the intestine. This process is called intestinal metaplasia.

Esophageal Cancer
Esophageal adenocarcinoma is the fastest growing cancer in the western world. Major risk factors for this cancer are Gastroesophageal Reflux Disease (GERD) and Barrett's esophagus.

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