Bruce's Story: Chronic Heartburn can be Linked to Esophageal Cancer
“Everyone knows someone affected by severe heartburn,” says Bruce Erbele, who had a nearly life-long journey with this condition and ultimately learned he suffered from gastroesophageal reflux disease (GERD) and Barrett’s esophagus.
Thankfully, Erbele’s GERD and Barrett’s esophagus are now gone and he and his family are happily sharing the message that people can benefit from new treatments that open a new chapter of a symptom-free life.
GERD is a chronic digestive disease that occurs when stomach acid, or sometimes stomach content, flows back into the food pipe (esophagus). The lining of the esophagus becomes irritated and causes GERD.
Long-standing GERD is a major cause of Barrett’s esophagus, which occurs when the lining of the esophagus becomes damaged from the continued reflux of gastric acid and bile into the esophagus.
“Anyone with five or more years of reflux symptoms is at risk for Barrett’s esophagus,” says Atilla Ertan, M.D., Director of the Ertan Digestive Disease Center of Excellence at Memorial Hermann Hospital and professor of medicine at The University of Texas McGovern Medical School.
With continued irritation of the lining of the esophagus, some patients progress to further cellular damage. This damage potentially can lead to abnormal cells, Barrett’s esophagus, which can transform to further precancerous cells and may lead to cancer.
“I grew up in a German household and we always had greasy food,” explains Erbele. “I remember having heartburn symptoms as a young child.”
During the 1980s his symptoms became especially bothersome. Heartburn, also called acid reflux, was increasingly part of Erbele’s life. “Many of us Baby Boomers continued to enjoy the greasy food we loved in our childhood. As an engineer in the oil and gas industry, I am always on the go and previously I did not always eat healthy meals.”
On the right path to a diagnosis
Many people can manage their frequent discomfort by changing their lifestyle or by taking prescription medicine or an over-the-counter remedy. When symptoms persist, it may be time to learn about other options.
A doctor can diagnose GERD by discussing your symptoms and performing further laboratory tests.
Common symptoms of GERD are:
- Heartburn (burning sensation behind the breast bone)
- Upper abdominal pain
- Difficulty swallowing or the sensation that food is hanging up or not passing down into the stomach properly
- Regurgitation of food or liquids, particularly when bending over or laying down, associated with a bitter taste in the mouth
“Some of my symptoms were mimicking a heart problem so my doctor ordered several tests,” Erbele says. “I did not have a heart problem but I was diagnosed with GERD and started taking a prescription medicine. Further testing in 2006 showed I had Barrett’s esophagus.”
Erbele was still suffering from heartburn and significant acid reflux when he was referred to Dr. Ertan in 2010. Erbele’s endoscopic work-up showed that he had Barrett’s with additional precancerous changes in his lower esophagus. He has had endoscopic ablation procedures by Dr. Ertan at the Ertan Digestive Disease Center and his Barrett’s with additional precancerous cells were all eradicated. However, despite his careful diet and medications, he continued to have significant reflux, with day and night regurgitation. Therefore, he was an excellent candidate for the FDA-approved endoscopic anti-reflux procedure, Stretta, to prevent reflux symptoms and minimize the recurrence of his Barrett’s.
“After providing excellent detailed information, Dr. Ertan swooped in and not only made Bruce’s life better but he saved it,” says Bruce’s wife of 35 years, Linda. “Dr. Ertan is great and his team is very supportive and compassionate. Dr. Ertan knows how much my husband means to me and after the endoscopic ablation procedure he said, I have good news: the Barrett’s esophagus and additional precancerous cells in the esophagus are gone. After the endoscopic anti-reflux procedure, Stretta, Bruce’s reflux symptoms, including his very disturbing long-standing regurgitation, are all resolved. You can imagine how happy and grateful we all are.”
At Memorial Hermann’s Ertan Digestive Disease Center, patients with Barrett’s esophagus receive multidisciplinary care from expert gastroenterologists, pathologists, radiologists, oncologists and surgeons and have treatment options ranging from medications and monitoring to endoscopic radiofrequency ablation, endoscopic mucosal resection, as well as endoscopic and surgical anti-reflux procedures.
Barrett’s esophagus: not to be ignored
"Because of the connection between Barrett’s esophagus and esophageal cancer, it is crucial that patients with Barrett’s esophagus see a gastroenterologist on a regular basis,” says Dr. Ertan.
At its early stage, esophageal cancer may not show any symptoms and will only be detected during an upper endoscopy and biopsy. In advance stages, symptoms include:
- Difficulty swallowing
- Weight loss, fatigue, weakness
- Painful swallowing
- Pain behind the breast bone
- Blood in the stool
“Our treatments were very effective for Mr. Erbele,” adds Dr. Ertan. “We were able to eliminate precancerous Barrett’s esophagus, and chronic reflux, and prevent the formation of esophageal cancer. We have over 1,200 patients with Barrett’s esophagus and our team of specialists is highly skilled regarding these patients with various advanced management modalities.
Feeling good at last
Looking back on his long journey to find relief from his digestive problem, Erbele admits it took a while to get the right answers until he met Dr. Ertan. “I feel great now,” he says. “I have lost close to 50 pounds, I no longer take prescription reflux medicine, I don’t have any reflux symptoms and my energy level is high.” He is proud that his body mass index (BMI) and sugar level are both good.
“Linda has been very supportive throughout the process to diagnose and treat this problem and she is committed to make sure I get healthy meals,” he adds.
His advice? “Don’t be afraid to talk about these symptoms with your doctor,” he explains. “Denial is your worst enemy. It is tempting to ignore the chronic reflux symptoms and I am so glad we didn’t.”