Avoiding Cancer with Barrett's Esophagus

Proton pump inhibitors linked to significant decrease in esophageal cancer risk

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) Barrett's esophagus occurs when cells of the esophagus change over time to resemble cells of the intestine, and the condition can put patients at risk of cancer. Researchers have found that one type of medication may lower this risk.

A recent review looked at previous studies on preventing cancer of the esophagus among people with Barrett's esophagus. This review specifically looked at people taking medications that prevent stomach acid from going into the esophagus.

These researchers found that the most common kind of acid-suppressive medication — called proton pump inhibitors (PPIs) — was linked to a significant decrease in esophageal cancer.

They suggested that PPIs be used in patients with Barrett's esophagus who show other risk factors for cancer.

"Talk to your doctor about options for controlling acid reflux."

Siddharth Singh, MBBS, of the Division of Gastroenterology and Hepatology at Mayo Clinic, led this review.

Barrett's esophagus is a condition in which the lining of the esophagus, or the tube that carries food to the stomach, becomes damaged due to stomach acid exposure.

Acid reflux, a disorder in which the stomach chronically sends stomach acid into the lower esophagus, is a strong risk factor for developing Barrett's esophagus.

Barrett's esophagus puts patients at risk of developing esophageal adenocarcinoma, or cancer in the esophagus.

One class of medications, called acid-suppressive medications, are designed to prevent damage to the esophagus by reducing the amount of acid that is regurgitated into the esophagus.

The most common types of acid-suppressive medications are proton pump inhibitors, or PPIs, which prevent the secretion of stomach acid into the esophagus, and histamine receptor antagonists (H2RAs), which decrease the production of acid.

This review looked at previous studies on acid-suppressive medications to see if they were linked to a decrease in esophageal cancer.

The researchers looked at trials and observational studies that evaluated the effects of acid-suppressive medications and reported instances of esophageal cancer.

In total, they looked at seven studies testing either proton pump inhibitors or H2RAs. The studies included a total of 2,813 patients with Barrett's esophagus and 317 cases of esophageal cancer or serious esophageal abnormalities.

The researchers found that using PPIs was associated with a 71 percent reduction in risk of esophageal cancer or esophageal abnormalities.

Additionally, PPIs were more effective for patients who had been using them for two years or more.

These researchers also found that H2RAs did not seem to have a significant effect on the risk of esophageal cancer or serious esophageal abnormalities.

The authors of this review suggested that doctors should use PPIs for patients with Barrett's esophagus who have many risk factors for developing esophageal cancer.

These authors also called for more research on preventing esophageal cancer in patients with Barrett's esophagus.

This review was published in Gut on November 12.

The researchers disclosed no competing interests. Information on funding was not available.

Review Date: 
November 25, 2013
Last Updated:
December 30, 2013