Gastroesophageal reflux disease (GERD) is a condition caused by the backflow of stomach contents into the esophagus. It is a common condition, affecting approximately 20% of the adult population.

One of the potential complications of GERD is the development of esophageal cancer. In this article, we will discuss how surgery can minimize the risk of esophageal cancer in GERD patients.

Background

GERD is caused by a dysfunction in the lower esophageal sphincter (LES), a ring of muscle at the bottom of the esophagus that opens to allow food and liquid into the stomach and closes to prevent stomach contents from refluxing into the esophagus.

When the LES is weak or relaxes too often, stomach acid and other contents can flow back into the esophagus, causing inflammation, irritation, and damage to the lining of the esophagus.

Over time, repeated damage to the esophagus can lead to changes in the cells that make up the lining.

If left untreated, these changes can progress to a condition called Barrett’s esophagus, in which the normal lining of the esophagus is replaced by abnormal cells. Barrett’s esophagus is a precancerous condition that increases the risk of developing esophageal cancer.

Current Treatment Options

The treatment of GERD typically involves lifestyle modifications, such as weight loss, dietary changes, and avoidance of trigger foods, as well as medications to reduce the amount of acid produced by the stomach.

However, these treatments may not be effective for all patients and may have unwanted side effects.

Surgery is an option for patients with severe GERD who do not respond to other treatments or who wish to avoid long-term medication use.

The most common surgical procedure for GERD is called fundoplication, which involves wrapping the upper part of the stomach around the LES to strengthen it and prevent reflux.

Minimizing Esophageal Cancer Risk through Surgery

Recent studies have shown that surgery for GERD may also reduce the risk of developing esophageal cancer in patients with Barrett’s esophagus.

In a study of over 9,000 patients with Barrett’s esophagus, those who underwent surgery had a significantly lower risk of developing esophageal cancer compared to those who did not have surgery.

One theory behind this finding is that surgery reduces the amount of acid and other harmful substances that reflux into the esophagus, thereby reducing inflammation and damage to the lining.

This, in turn, may reduce the risk of developing Barrett’s esophagus and esophageal cancer.

Candidates for Surgery

Not all patients with GERD are candidates for surgery. Surgery is typically reserved for patients who have severe, persistent symptoms that are not relieved by medications or lifestyle modifications, or who wish to avoid long-term medication use.

Prior to considering surgery, patients will undergo various diagnostic tests to confirm the diagnosis of GERD and evaluate the severity of the disease.

These tests may include an upper endoscopy to look for signs of inflammation or damage to the esophagus, as well as measurements of the pH and pressure in the esophagus to confirm the presence of reflux and evaluate the effectiveness of the LES.

Potential Risks and Complications

As with any surgery, there are potential risks and complications associated with surgery for GERD. These may include bleeding, infection, difficulty swallowing, and damage to nearby organs or structures.

Prior to surgery, patients should discuss these risks with their surgeon and weigh the potential benefits of surgery against the risks and potential complications.

Conclusion

Surgery is a potential option for patients with severe GERD who do not respond to other treatments or who wish to avoid long-term medication use.

Recent studies have shown that surgery may also reduce the risk of developing esophageal cancer in patients with Barrett’s esophagus. However, surgery is not appropriate for all patients and should be discussed with a healthcare provider on a case-by-case basis.