Determining foods to avoid when managing Barrett’s esophagus |

Determining foods to avoid when managing Barrett’s esophagus

Coffee may predictably cause reflux symptoms in some people, in others, it causes no symptoms at all. The key to managing Barrett’s esophagus is controlling esophageal reflux.

Dear Mayo Clinic: I was diagnosed with Barrett’s esophagus three months ago and was given some diet instructions, including eliminating alcohol and caffeine. Why is this necessary? Is it still possible for me to have an occasional alcoholic drink? Is decaffeinated coffee OK?

Answer: One of the main goals for the management of Barrett’s esophagus is controlling esophageal reflux. The diet guidelines you were given often can help control reflux and reduce its symptoms. But if symptoms don’t bother you when you have those foods or beverages, then you may not need to avoid them completely.

In Barrett’s esophagus, part of the normal tissue in the tube connecting your mouth and stomach — the esophagus — is replaced by tissue similar to the intestinal lining. Barrett’s esophagus is caused by gastroesophageal reflux disease, or GERD. Everyone who develops Barrett’s esophagus has, or has had, GERD. But not everyone experiences symptoms. In some people, the symptoms of reflux are readily apparent. They include heartburn, regurgitation, throat clearing, hoarseness, nausea or indigestion. But some people with Barrett’s esophagus don’t have reflux symptoms. Or they may have them for some time, but the symptoms go away.

How the disease develops

The reason for lack of symptoms in some people is due, in part, to the way Barrett’s esophagus develops. The medical definition of Barrett’s esophagus is intestinal metaplasia of the esophagus. That means the normal cells of the esophagus, called “squamous cells,” are replaced by intestinal cells. “Metaplasia” means the replacement of one cell by another cell. When metaplasia happens, the first type of cell usually is more vulnerable to injury than the type of cell that replaces it.

In Barrett’s esophagus, the body decides to, in effect, wallpaper the esophagus with intestinal cells. This decision is due to GERD. The intestines are located just beyond the stomach, and the stomach produces a significant amount of acid. Some of the excess acid from the stomach passes into the intestine, and the intestinal cells aren’t irritated by it. So when intestinal cells replace squamous cells in Barrett’s esophagus, acid reflux isn’t as damaging to the esophagus. Because intestinal cells are more resistant to acid, some people with Barrett’s esophagus do not feel the effects of the reflux.

Triggered by certain foods

In people with Barrett’s esophagus who are affected by reflux symptoms, the symptoms may be triggered by certain foods, especially spicy, citric or hot foods, as well as other stimuli, such as alcohol and coffee. These foods and beverages have a tendency to cause symptoms because they reduce pressure in the lower esophageal sphincter, and that allows more acid to come into the esophagus. They also may act as an irritant, and they can affect the way the stomach empties, both of which can lead to symptoms.

The severity and frequency of symptoms caused by diet varies quite a bit from one person to another. For example, whereas coffee may predictably cause reflux symptoms in some people, in others, it causes no symptoms at all. And in some cases, if certain diet choices cause symptoms before the patient is treated with an acid-suppressing medication, symptoms may go away with those medications. The most common medicines used to suppress acid are proton pump inhibitors and H2 blockers.

When certain foods and beverages cause reflux symptoms, it would be wise to avoid them or use them sparingly. If they do not cause symptoms, or if acid-suppressing medications prevent symptoms, then it’s likely that you don’t need to completely eliminate those foods and beverages from your diet, and you may use them in moderation.

Before you decide which foods and beverages to avoid — or not — due to Barrett’s esophagus, check with your health care provider to make sure that your choices are a good fit for your health overall.

Categories: News | Health Now
TribLIVE commenting policy

You are solely responsible for your comments and by using you agree to our Terms of Service.

We moderate comments. Our goal is to provide substantive commentary for a general readership. By screening submissions, we provide a space where readers can share intelligent and informed commentary that enhances the quality of our news and information.

While most comments will be posted if they are on-topic and not abusive, moderating decisions are subjective. We will make them as carefully and consistently as we can. Because of the volume of reader comments, we cannot review individual moderation decisions with readers.

We value thoughtful comments representing a range of views that make their point quickly and politely. We make an effort to protect discussions from repeated comments either by the same reader or different readers

We follow the same standards for taste as the daily newspaper. A few things we won't tolerate: personal attacks, obscenity, vulgarity, profanity (including expletives and letters followed by dashes), commercial promotion, impersonations, incoherence, proselytizing and SHOUTING. Don't include URLs to Web sites.

We do not edit comments. They are either approved or deleted. We reserve the right to edit a comment that is quoted or excerpted in an article. In this case, we may fix spelling and punctuation.

We welcome strong opinions and criticism of our work, but we don't want comments to become bogged down with discussions of our policies and we will moderate accordingly.

We appreciate it when readers and people quoted in articles or blog posts point out errors of fact or emphasis and will investigate all assertions. But these suggestions should be sent via e-mail. To avoid distracting other readers, we won't publish comments that suggest a correction. Instead, corrections will be made in a blog post or in an article.