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Damaged Esophagus?

What kind of diet and supplement regime do you recommend for someone with Barrett's esophagus?

Answer (Published 6/16/2006)

Barrett's esophagus represents damage to the lining of the esophagus from gastroesophageal reflux disease (GERD), in which stomach acid backs up, causing heartburn. The normal tissue changes as a result of constant irritation, with regular cells transforming to resemble those found in the intestines. This process of cell transformation, known as "metaplasia," is considered a precancerous condition and occurs in about 10-15 % of people who have long-term GERD. Patients have less discomfort once the cells have changed; however, 5 to 10 percent of them will go on to develop esophageal cancer, a particularly deadly disease.

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Once esophageal cells change they will not revert back to normal, so treatment should focus on preventing further damage by stopping acid reflux from the stomach.

You're at greatest risk of Barrett's esophagus if you've had long-term heartburn and acid reflux, but remember: only a small percentage of people with GERD develop the disorder. In addition to heartburn, symptoms may include difficulty swallowing, vomiting red blood or blood that looks like coffee grounds, black, tarry or bloody stools or sudden weight loss.

A combination of life-style changes, supplements and diet can help you deal with Barrett's esophagus. First of all, I suggest switching to an anti-inflammatory diet:

  • Eliminate polyunsaturated vegetable oils and partially hydrogenated oils. Also eliminate sources of trans-fatty acids such as margarine and vegetable shortening.
  • Instead of polyunsaturated oils, rely on olive oil and increase your intake of omega-3 fatty acids by eating salmon, sardines, walnuts, freshly ground flax seeds and soy foods. If you don't like fish, take a fish oil supplement containing both DHA and EPA.
  • Make sure your diet includes plenty of fresh fruits and vegetables, particularly those high in antioxidants. A half cup of blueberries packs as much antioxidant power as five servings of peas, carrots, apples, squash, or broccoli.

In addition, I recommend the following:

  1. Take deglycyrrhizinated licorice (DGL) to soothe the esophageal lining. Chew two tablets slowly before each meal or between meals, or take one half teaspoon of the powder before meals. Continue as long as you have symptoms.
  2. Reduce or eliminate alcohol consumption (if you take an occasional drink, make sure there is food in your stomach).
  3. If you smoke, stop.
  4. Avoid coffee and decaf, both of which can irritate the digestive system. Switch to soothing chamomile tea.
  5. Avoid any food you find irritating - chocolate, peppermint, raw onions, tomatoes or citrus fruits are common culprits.
  6. Don't eat within two to three hours of bedtime.
  7. Take my antioxidant formula.
  8. Try visualization, a mind/body technique that could help you manage your symptoms.
  9. Elevate the head of your bed by using blocks or foam wedges to reduce reflux while sleeping.
  10. Take two enteric-coated baby aspirin a day to reduce your risk of cancer.

The goal is to get the disorder under control quickly. Prescription medications such as Prilosec, Prevacid, Nexium, Aciphex or Protonix can help soothe irritated tissues by blocking stomach acid production. The over-the-counter drugs Pepcid, Tagamet, Axid and Zantac can also help relieve symptoms. Surgery is often a last resort for people with severe long-term reflux that is resistant to treatment.

Andrew Weil, M.D.

For more information on the anti-inflammatory diet click here.

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