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GERD, pregnancy, acid reflux. On ranitidine medication. Will I get cancer of the esophagus?

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Hello, I am worried about gerd and Barretts oesophagus. I am a 35 (nearly 36) year old white female. I have had gerd symptoms in 6 pregnancies over the past 10 years, which I treated symptomatically with Gavascon. Inbetween pregnancies 1, 2 and 3 I was symptom free as far as I was aware. Inbetween pregnancies 4 and 5 I became bulimic for 18 months, which caused some acid damage to my teeth. I was also bulimic for 6 months before my last pregnancy (I am well now and will NEVER return to it). It was only during my 6th pregnancy that I became aware of the damage acid reflux can do. When my symptoms did not clear immediately after having my last baby 3 months ago I saw my GP who prescribed 150mg of ranitidine 2x daily. I have been completely symptom free since. I am now extrememly worried that I may be a ticking time bomb for barretts or worse cancer of the oesophagus. I have never smoked and I do not drink. I am not overweight and exercise regularly. I live in the UK.
Posted Thu, 26 Apr 2012 in GERD
Answered by Dr. Poorna Chandra K.S 6 hours later
Hi and thanks for the query.

Pregnancy increases the tendency of reflus by relaxing the lower Esophageal sphincter and increasing the intra abdominal pressure. The reflux may completly subside after delivery or persist to variable extent depending on the lower esophageal sphincter anatomy or presence of hiatus hernia.

Barret's mucosa develops after a prolonged period (usually >5yrs) of unabated acid exposure and damage. Once Barret develops, if reflux continues then a percentage of people might develop dysplasia or disorganisation and a smaller percentage (<10%) go on to develop esophageal carcinoma over ~5 -10yr period. There are no specific symptoms to differentiate between these stages.

Hence it is best to undergo an upper GI endoscopy and 4 quadrant biopsy if there is an indication of columnar lined esophagus or Barret's mucosa.

Meanwhile take some proton pump inhibitors (as they are shown to be superior than ranitidine in supressing acid secretion) and prokinetics.

Hope I have answered your query. Please feel free to write back to me if you have any doubts.

Wishing you good health.

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