Doctors have long been puzzled why some GERD patients develop Barrett’s esophagus while others never do. To search for an explanation, the Baylor Scott & White research team analyzed cells from patients who had GERD and Barrett’s esophagus as well as cells from people who suffered from GERD but had not developed the pre-cancerous condition.
The results showed cells from the two groups of GERD patients reacted differently when exposed to bile and acid, common substances in stomach contents that reflux back into the esophagus. In the cells from people with Barrett’s esophagus, the bile-acid mixture triggered inflammation and the induction of the CDX2 gene known to be associated with esophageal cancer.
However, the study, published in the journal GUT, found there is a way to block this gene change. All it took was exposing the cells to aspirin. This finding indicates the drug may protect against Barrett’s esophagus and eventual esophageal cancer.
What’s more, the researchers discovered aspirin could offer addition protection to people who already have developed Barrett’s esophagus and are treated with radiofrequency ablation, an endoscopic procedure used in recent years to burn away the pre-cancerous cells associated with Barrett’s.
If treated with aspirin before and after the ablation, the researchers believe it could keep the abnormal cells from regrowing in the esophagus, blocking Barrett’s esophagus from reoccurring, and preventing a progression to cancer.
The National Institutes of Health is supporting a clinical trial through MD Anderson Cancer Center to document if taking aspirin can keep Barrett’s esophagus from recurring in patients who have abnormal esophageal tissue associated with the condition removed through ablation. Baylor Scott & White Research Institute scientists are conducting the lab work in this collaborative study.
"For patients who have been shown to develop Barrett's, this research suggests that putting them on aspirin following the RFA procedure may delay or prevent the intestinal lining from returning," Souza said.
If you are interested in taken baby, or low-dose, aspirin regularly for possible cancer prevention, to lower your risk for heart attacks, or for any other reason, it’s important to talk to your doctor and make sure it is safe for you. In some people, regular use of normal-sized aspirin can cause significant side effects, including internal bleeding, according to the American Heart Association.
March 30, 2020
Christopher Nystuen, MD, MBA