DEAR DR. DONOHUE: I had heartburn for a number of years, and I took Tums for it. In the past year, I lived on Tums, so I saw my family doctor, who sent me to a gastroenterologist. He examined my esophagus with a scope and took biopsies. He called to tell me I need another scope in a year because I have Barrett’s esophagus. What is that? – H.M.

ANSWER: Everyone has heard of heartburn and hiatal hernia. Most everyone has heard of GERD – gastroesophageal reflux disease, the medical name for heartburn. Few have heard of Barrett’s esophagus, a consequence that happens to some people who have heartburn.

The upward spurting of stomach acid and digestive juices into the esophagus causes the pain of heartburn. It can also transform the normal flat cells of the esophagus’s lining into column-shaped cells, the kind of cells that line the intestinal tract. That change constitutes a Barrett’s esophagus, and it happens to one of every 10 heartburn patients.

The danger of Barrett’s esophagus lies in a further transformation into cancer of the lining of the esophagus, and that takes place in about 5 percent of those who have Barrett’s. That’s why you need follow-up scope exams and follow-up biopsies. Cancer of the esophagus is a terrible ordeal unless it is caught early, when cure can be spoken of.

Former teaching had it that treatment of heartburn had little effect on stopping Barrett’s esophagus from progressing to cancer. However, it appears that medicines called proton pump inhibitors (Nexium, Prevacid, Prilosec, Protonix and Aciphex) might retard such changes. These medicines turn off the stomach’s production of acid. Even so, the surveillance of the esophagus through scope exams must continue.

DEAR DR. DONOHUE: Please clear up these unbelievable things I have heard.

1. Babies are born without kneecaps.

2. Black people do not turn gray unless they have a white ancestor.

3. Bread has fewer calories after it is toasted. – D.K.

ANSWER: Babies are born with kneecaps.

Blacks become gray-haired without having any white ancestors.

The toast question gave me the most trouble. I know that toasted bread has more fiber than untoasted bread. Toasting causes a change in the bread constituents that turns them into substances that resemble lignin, a natural fiber.

The amount of calories in toast versus bread is a hurdle for me. Bowes & Church’s Food Values of Portions Commonly Used is a standard reference for calorie, carbohydrate, protein, fat, vitamin and mineral content of just about any food you can name. Its only reference to toast mentions that white bread toast has a slightly greater amount of carbohydrate than does untoasted white bread, and, by inference, it would have slightly more calories. Why this is so is left unexplained.

I need reader input to answer this question. Help.

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.