— Irene, New Jersey Belching has a number of causative factors and may be related to habit or to an irritant of the gastrointestinal tract that causes air to move upwards to the mouth, most commonly after eating. Certain foods, such as carbonated beverages, contain a lot of gases that can initiate or worsen the symptoms of belching. However, belching itself has not been clearly associated with a risk of developing esophageal cancer. Barrett’s esophagus, a change in the esophageal lining from normal esophageal mucosa to intestinal type mucosa is a risk factor for developing esophageal factor. Indeed, Barrett’s esophagus may be caused by gastroesophageal reflux disease (GERD), a common condition related to a lowering of lower esophageal pressure after eating, causing stomach contents to reflux into the esophagus. Heartburn, chest pain, hoarseness, and even asthma are more common complications of GERD than belching, although persistent belching warrants an examination of the esophagus for GERD. The precursor the doctor is most likely alluding to is Barrett’s esophagus and this needs to be watched closely to see whether any additional signs or risks of cancer develop. If the doctor found evidence of inflammation or GERD, then lifestyle changes including weight loss, avoidance of foods that lower esophageal sphincter pressure such as fatty foods, alcohol, caffeine, are warranted. Other strategies include waiting two hours before reclining after a meal, and lifting the head of the bed up with boards so that the head is elevated about the feet. In addition, acid-blocking agents, such as the proton pump inhibitors (Prilosec, etc) will alleviate most of the symptoms. Q2. I was diagnosed with stomach inflammation, diverticulosis, hiatus hernia, and internal and external hemorrhoids. In short, I’m a gastric mess! Are there any dangers to my health, such as a tendency to develop cancer of the stomach or colon? — Marissa, New Jersey Stomach and colon cancers are associated with different risk factors. Helicobacter pylori — the bacteria that can cause ulcers — is the most important risk factor for stomach cancer. This bacterium, which also causes gastritis, is so common that an estimated 60 to 70 percent of the world’s population is infected. However, only a small fraction of infected patients develop stomach cancer. In the United States, both Helicobacter pylori infection and stomach cancer are much less common than in underdeveloped countries. If your stomach is inflamed, get tested for the presence of Helicobacter pylori and get treated if it’s found. The excessive use of nitrites/nitrates have also been associated with stomach cancer. In contrast to stomach cancer, colon cancer has been associated with cigarette smoking and “Western” diets. Diverticulosis, hiatal hernias, and internal/external hemorrhoids are not directly related to cancer risk. Hiatal hernias have been associated with gastroesophageal reflux disease (GERD). In turn, severe and/or untreated GERD may lead to Barrett’s esophagus, a risk factor for esophageal cancer. Make sure to tell your health care provider if you have a family history of either disease. Learn more in the Everyday Health Digestive Health Center.
