Endoscopy for persistent heartburn

The government has recently launched its next phase of the ‘Be Clear on Cancer campaign’. There have already been campaigns in relation to bowel cancer (blood in the poo)and lung cancer (cough for more than three weeks) as well as the ‘blood in the pee’ campaign.

This time the focus is on oesophageal (gullet) cancer. The message is simple. People who suffer with persistent heartburn should have an endoscopy to rule out both cancer and its precursor, Barrett’s oesophagus. You can download a copy of the campaign leaflet here.

I was on the committee that advised the Department of Health about this campaign. It was a difficult call. One in 10 people suffers with heartburn at least every month. That means that an awful lot of people could potentially need endoscopy. On the one hand we could swamp national NHS endoscopy service provision but on the other we might find many more cancers.

There are approximately 8000 new diagnoses of oesophageal each year in the UK. If we could prevent even a quarter of these, it would result in 2000 lives saved each year. The decision by the expert group was that it was worth risking putting extra pressure on services. The final decision was made only after a pilot had been done in one part of the country. This was successful in both increasing the number of cancers detected whilst not completely overwhelming NHS endoscopy services. We look forward to seeing improved outcomes over the next few years. The UK has lagged behind Europe in quality of outcome for all cancers and the concerted government effort to improve this is definitely bearing fruit.

There are some general which bear repeating. These are all included in the campaign leaflet.

• If you have had heartburn most days for 3 weeks or more you need to see your doctor.
• Heartburn often feels like a burning feeling in your chest.
• Even if your heartburn is better after you take medicine you still need to see your doctor.

You should also see your doctor if you notice feeling full very quickly, have bad burping or trapped wind or feel sick or are being sick. If food gets stuck or trapped on the way down to your stomach, this is another important reason to be checked.

Remember that most people will not have cancer, but some will have pre-cancerous abnormalities such as Barrett’s oesophagus which can be monitored regularly.

One of the pleasures of having access to the private sector is that it is much easier to get access to high-quality gastroscopy without waiting for a long period for the referral to go through to your local hospital and for a test slot to become available. All our specialists offer this test routinely and it is usually available within a few days.

If you suffer from persistent heartburn and have private health insurance, please follow the government’s advice and have yourself checked out by a specialist private consultant gastroenterologist. Our doctors would be delighted to help you.