Can Long-Term Acid Reflux Cause Esophageal Tumors? Your Diagnosis

Chronic gastroesophageal reflux disease (GERD) can lead to the development of esophageal tumors?

Hello, I previously underwent an endoscopy at another hospital, where it was found that in addition to a mild gastric ulcer, there was also a tumor in my esophagus (approximately one-third of the esophagus).
The doctor performed a biopsy during the examination and asked me to return for the results.
When I went back to see the report, he only mentioned that it "seemed" benign and stated that it was caused by long-term gastroesophageal reflux disease (GERD).
He mentioned that to determine if it is malignant, the entire tumor would need to be removed.
My question is, is removal absolutely necessary, or should I seek a second opinion elsewhere? Additionally, what could be the causes of the tumor in my esophagus? Please provide a detailed response.
Thank you!

eileen, 20~29 year old female. Ask Date: 2005/04/26

Dr. Yuan Hongdao reply Gastroenterology and Hepatology

Hello, esophageal tumors may be congenital, caused by viral infections, result from chronic inflammation (such as gastroesophageal reflux disease), or related to individual predispositions.
Generally, an upper endoscopy can provide a preliminary assessment of whether the tumor is benign or malignant, but a definitive diagnosis relies on pathological examination of biopsy samples.
However, sometimes tumors located in the submucosal layer may not be sampled during endoscopy, and there is a possibility that the malignant portion may be missed.
Of course, complete surgical resection followed by pathological examination is the best diagnostic method, but the risks associated with esophageal surgery are significant, and surgery is typically not performed solely for diagnostic purposes.
Given your situation, it is unlikely for a 23-year-old to have a malignant tumor, but a tumor occupying one-third of the esophagus seems too large.
It is advisable to closely monitor with endoscopy and biopsy, and if necessary, consider a computed tomography (CT) scan or endoscopic ultrasound.
Sincerely, Dr.
Chen Zhi-Ping, Internal Medicine.

Reply Date: 2005/04/26

More Info

Long-term acid reflux, also known as gastroesophageal reflux disease (GERD), can indeed lead to serious complications, including the development of esophageal tumors. The relationship between chronic acid reflux and esophageal tumors is primarily linked to a condition called Barrett's esophagus, which occurs when the normal squamous cells lining the esophagus are replaced by columnar cells, a process known as intestinal metaplasia. This change is often a response to the chronic irritation caused by stomach acid. Over time, Barrett's esophagus can increase the risk of developing esophageal adenocarcinoma, a type of cancer.

In your case, the presence of a tumor occupying about one-third of the esophagus is concerning, and the fact that it was noted during your endoscopy warrants careful evaluation. The initial biopsy results indicating that the tumor might be benign are reassuring; however, the definitive diagnosis often requires further investigation. It's important to understand that while some tumors can be benign, others may be malignant, and the only way to confirm this is through thorough pathological examination.

Regarding your question about whether the tumor must be surgically removed, it is essential to consider several factors. If the tumor is large and causing symptoms, or if there is a significant concern about malignancy, surgical intervention may be necessary. However, if the biopsy results suggest that the tumor is benign and there are no alarming features, your healthcare provider may recommend a watchful waiting approach with regular monitoring through endoscopy.

It is also advisable to seek a second opinion, especially if you have concerns about the initial diagnosis or treatment plan. A different gastroenterologist may provide additional insights or suggest alternative diagnostic tests, such as imaging studies (like a CT scan) or endoscopic ultrasound, which can help assess the tumor's characteristics and its relationship to surrounding tissues.

The underlying causes of esophageal tumors can vary. Chronic irritation from acid reflux is a significant risk factor, but other factors such as smoking, excessive alcohol consumption, obesity, and certain dietary habits can also contribute to the development of esophageal tumors. It is crucial to address these risk factors through lifestyle modifications, such as maintaining a healthy weight, avoiding trigger foods, and quitting smoking if applicable.

In summary, while long-term acid reflux can lead to serious complications, including esophageal tumors, not all tumors are malignant. It is essential to follow up with your healthcare provider for further evaluation and to discuss the best course of action for your specific situation. Regular monitoring and lifestyle modifications can help manage your symptoms and reduce the risk of further complications. If you have ongoing concerns, do not hesitate to seek a second opinion or further testing to ensure that you receive the most appropriate care.

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