For a few, heartburn leads to cancer
DEAR DR. DONOHUE: I am writing concerning your article on heartburn. I am a long-term survivor of esophageal cancer — 10½ years. I was diagnosed early. For years I had suffered from heartburn and practically lived on antacids. My primary-care physician sent me to have an endoscopic exam of my esophagus, and Barrett’s esophagus was found. I was then scoped annually, and in five years, esophageal cancer was found. As a survivor of this cancer, I am disappointed that you don’t mention Barrett’s esophagus. You are in an ideal position to promote esophageal cancer awareness. — M.L.
ANSWER: Heartburn’s official name is GERD — gastroesophageal reflux disease — and it’s the upward spouting of stomach acid and digestive juices into the esophagus. In some, after years of reflux, the lining of the lowermost part of the esophagus undergoes a transformation. The lining cells become elongated. That change marks Barrett’s esophagus. The only way to discover the change is through a scope examination of the esophagus along with a biopsy.
Barrett’s esophagus isn’t cancer, and it doesn’t produce any symptoms. People with it feel the same as they did before it was discovered. However, the changes of Barrett’s esophagus can evolve into esophageal cancer. Some characteristics of the changes indicate a greater risk for cancer development. One is the length of involved tissue. If it’s longer than 3 cm (1.2 inches), the risk of cancer increases.
When Barrett’s changes are found, the doctor puts the person on a schedule of surveillance scope exams to catch cancer changes early.
There are many ways of dealing with high-risk Barrett’s. I’ll mention one that is being used often. It is radiofrequency ablation. Here the doctor uses radio waves to get rid of the abnormal cells and tissues. Those waves generate heat that destroys them.
Neither M.L. nor I want to frighten people who have heartburn. They are not doomed to cancer. They should, however, be aware of these issues and follow their doctor’s suggestions for scope exams of the esophagus.
The booklet on heartburn and hiatal hernia presents the details and complications of these conditions. To order a copy, write: Dr. Donohue — No. 501, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.
DEAR DR. DONOHUE: I am 80 and always thought that we have only one intestine. I found out we have two, one large intestine called the colon and a small intestine. My question is: I know how to clean my large intestine, but how do I clean the small intestine? The large intestine sends matter into the small intestine. I thought the opposite. I know good health starts with a clean intestine. — K.B.
ANSWER: We have only one intestinal tract. The first portion of the tract is the small intestine. It’s called “small,” but it’s quite long, 20-plus feet. The small intestine receives food from the stomach. It’s the place where nutrients are digested and absorbed. The small intestine joins the colon (large intestine), which is around 5 feet long. In the colon, water is absorbed from watery stool, and it changes into a solid residue.
You don’t have to cleanse either the small intestine or the colon. Nature does that for us in spite of dire warnings to the contrary.
DEAR DR. DONOHUE: Some time ago, you wrote about the antibiotic erythromycin and its side effects. My husband is having eye surgery, and his instructions are to use this drug in ointment form. Please educate us about this antibiotic. — D.P.
ANSWER: Erythromycin has been in use since the 1950s. It has had an admirable record of success in treating many bacterial infections. It has few side effects. It can cause rashes, heartbeat disturbances liver malfunction and deafness. These events are extremely rare. Oral erythromycin might lead to nausea, vomiting, abdominal cramps and diarrhea.
Erythromycin ointment almost never has these side effects. Eye irritation is possible but not common.
Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.