Could your heartburn turn into Esophageal Cancer?

But heartburn, which is a symptom of acid reflux, can actually be a pretty big deal.

“Acid reflux is what happens when stomach contents go up the esophagus,” explains Raja M. Flores, M.D., chairman for the Department of Thoracic Surgery for the Mount Sinai Health System and director of the Thoracic Surgical Oncology Program at The Tisch Cancer Institute. “The stomach secretes acidic fluid to digest food, but sometimes it also contains basic fluids like bile. The esophagus is only meant to go one way: down. So when stuff comes back up, like a mild form of vomiting, that can irritate the esophagus.”

Irritation is not just annoying in the short-term; over time, acid reflux will scar the surface of the esophagus, leading to a precancerous condition called Barrett’s esophagus. With Barrett’s, all that scarring changes the lining of the esophagus to more closely resemble the lining of the intestines—and that can eventually lead to cancer.

The problem with all this? Early stage esophageal cancer feels like...nothing. It isn’t until people start having trouble swallowing—meaning the cancer has grown to the point where it’s blocking food from going down the esophagus smoothly—that they start to question whether something’s wrong, says Flores.

But while acid reflux is common, esophageal cancer is not—there about 17,000 new cases of esophageal cancer per year in the United States, according to the American Cancer Society. If you’re not sure whether you should be concerned about your heartburn, take note of its frequency. Twenty to 30 percent of adults experience some type of gastroesophageal reflux disease (GERD), like heartburn, weekly, and Flores says that’s nothing to worry about. “It’s the people who are experiencing it multiple times a day that are at risk of developing cancer,” he explains. “Not everyone who has heartburn or acid reflux will get cancer, but almost all of those who have cancer have experienced reflux.”

Esophageal cancer can take years to develop, which means catching it early can prevent you from experiencing a world of pain (it’s not necessarily a terminal cancer, but the surgery, which involves removing the esophagus, creating a new tube from your stomach, and sewing it up into your neck, is intensive and very invasive). So heartburn is not the kind of thing you want to self-diagnose. “A lot of people with reflux will take a ton of Tums,” says Flores. “But that’s not the answer. If you’re taking a lot of Tums, there’s a reason for it. Get to a doctor and get an endoscopy so a doctor can look directly in there and be sure there’s no cancer.”

There are also some things you can avoid to prevent acid reflux and the chain of health issues it can set off. “Smoking can lead to esophageal cancer. Frequent alcohol consumption is also linked to esophageal cancer, because alcohol causes injury to the lining of the esophagus,” says Flores. Too much caffeine and chocolate can relax the sphincter that connects the esophagus to the stomach, causing more stuff to go back up the esophagus. Spicy foods, tomato products, smoked and cured meats, and citrus fruits have all been linked to acid reflux as well. Your weight could also be a factor. The rise in obesity rates has led to an increase in esophageal cancer cases, says Flores—all that extra pressure on your abdomen forces fluid back up into the chest, which leads to more reflux.

If you’re experiencing heartburn several times a week or on a daily basis, head to your doc to find out what’s up ASAP. Prevention is key when it comes to esophageal cancer. “If you have reflux, get scoped so you can get put on meds to prevent more reflux, which can prevent you from developing cancer,” says Flores. It’s a simple as that. Staying ahead of the game here is what can save you from a whole lot of discomfort—and potentially save your life.