What Causes Acid Reflux?

Barren’s esophagus

The most important of these is Barren’s esophagus. In 1950, British surgeon N. R. Barrett wrote a paper entitled ‘Chronic peptic ulcer of the esophagus and esophagitis’. It was published in the British Journal of Surgery, since when the name Barren’s esophagus has been given to all such cases.

People with Barren’s esophagus have two main symptoms. They have heartburn, which is usually severe, and their food tends to come back into their mouth (‘regurgitation’). Even when they have not been eating, those with Barren’s find bitter gastric secretions welling up into their mouths.

If the condition is not diagnosed early and treated, they develop difficulties in swallowing (‘dysphagia’), and a severe ‘boring’ pain in the centre of the chest that can travel through to the back. The dysphagia is a sign that scarring in the esophagus is causing it to narrow (a stricture), and that food can no longer pass through it easily.

The second is a sign of an ulcer in the esophagus. Both are serious developments that must be treated. If they are not, the next stage can be bleeding (haemorrhage) from the ulcer, or even perforation of the ulcer into the chest cavity, with all the damage that can be wrought if the lungs are exposed to the stomach’s digestive juices.

In Barren’s esophagus the flaw is in the lining of the lower end of the esophagus. Instead of it having the usual tough, skin-like cells that line the normal esophagus, its lining is much more like the lining of the stomach wall, with glands and other cells that are much more susceptible to acid attack, but that do not produce adequate amounts of the mucus that normal stomach cells generate to protect themselves.

As the Barren’s esophagus is also often linked to a hiatus hernia, it is repeatedly exposed to the stomach’s digestive juices. The ensuing irritation and inflammation lead to the strictures and the ulcers. There are even acid-producing cells within the Barren’s tissue itself, so that it contains the mechanism of its own destruction.

Obviously people with a Barren’s esophagus are at higher risk of serious illness than others with uncomplicated GERD. Without further tests, too, it is difficult to tell just from the symptoms alone whether the person has it or not. This is why any suspicion of Barren’s esophagus (say if the symptoms are severe or there is constant chest pain or difficulty in swallowing) should be confirmed by endoscopy.

Why people have a Barren’s esophagus in the first place is still a matter of argument among the experts. It was initially thought to be a defect that people were born with. Opinion has now swung to its being acquired after birth, although when and why is not yet known.
Heart burn, acid reflux and GERD are all too common – affecting up to 20% of the Western population. Known as Gastro Esophageal Reflux Disease or GERD, it is affected by our lifestyle and fast pace of living. By making simple lifestyle changes and following an acid reflux diet you will find acid reflux and GERD can be cured completely.


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