Gastro-oesophageal reflux disease: not so benign

TO THE EDITOR: I read with interest the editorial by Duggan and Harvey, which highlighhted the important association between adenocarcinoma of the oesophagus and gastro-oesophageal reflux. Surgeons who treat patients with oesophageal carcinoma would agree that there has been a significant increase in the incidence of this problem in recent decades, and this has not been well understood by the wider medical community.

While I agree that a strategy which prevents the cause of gastro-oesophageal reflux should be sought, its aetiology is unknown, and so preventing reflux is not feasible at present. Furthermore, current medical treatments do not stop reflux; antisecretory medication reduces the amount of acid in refluxing gastric contents but reflux continues to occur. The importance of this in the development of oesophageal adenocarcinoma is uncertain.