In gastroesophageal reflux disease (GERD), stomach contents flow
up and into the esophagus, which causes heartburn. Medicines
called proton-pump inhibitors (PPIs) decrease the amount of acid
the stomach makes. If heartburn resolves with PPIs, GERD is the
likely diagnosis. Another test for GERD is to examine the
esophagus with an instrument passed through the mouth (upper
endoscopy). Narrowing of the esophagus (strictures) and
esophageal cancer are long-term complications of GERD.
Approximately 10% of people with long-term heartburn develop an
abnormal lining to the esophagus (called Barrett esophagus) and
a higher risk for esophageal cancer. Before cancer develops, the
cells lining the esophagus may show dysplasia (precancerous
changes). Barrett or dysplasia can be diagnosed with endoscopy
and biopsies. The benefits of using endoscopy to routinely
screen people with GERD for Barrett and cancer are uncertain.
Many people have GERD, but few develop cancer. The ACP developed
these recommendations to help doctors