Chronic Heartburn Could Signal More Serious Health Risks, Experts Warn

For most people, heartburn is merely an occasional annoyance that disappears after taking an over-the-counter remedy. However, medical experts caution that chronic heartburn could be a warning sign of more dangerous conditions that may lead to cancer in some cases.

Approximately 10% of individuals with chronic gastroesophageal reflux disease (GERD) will develop Barrett’s esophagus, a condition characterized by abnormal cell changes in the lining of the lower esophagus. These cellular changes make the tissue more susceptible to becoming cancerous. Research indicates that between 3% and 13% of those with Barrett’s esophagus will eventually develop esophageal cancer.

“Your stomach is designed to handle acid. Your esophagus is not,” explains Dr. Daryl Gioffre, a Florida-based gut health specialist and certified nutritionist. “With reflux, the danger is not the burn in the chest or throat — the real danger is the constant backflow of acid traveling the wrong way.”

In a properly functioning digestive system, the lower esophageal sphincter—which Gioffre describes as the “acid gate”—prevents stomach acid from flowing backward. This sphincter muscle serves as a barrier between the stomach, which has protective mucus and specialized cells, and the vulnerable esophagus.

“But when the gate gets weak, it relaxes or stays slightly open, and acid slips back up the wrong way,” Gioffre notes. Several factors can weaken this protective barrier, including magnesium deficiency, high stress levels, alcohol consumption, poor sleep, dehydration and late-night eating habits.

When stomach acid repeatedly contacts the esophageal tissue, it causes persistent irritation similar to a “slow chemical burn,” according to Gioffre, who authored health books including “Get Off Your Acid” and “Get Off Your Sugar.” This ongoing irritation can trigger cellular changes in the esophageal lining.

“These new cells are no longer normal esophageal cells — they begin to shift into cells that look more like stomach lining, because those cells can tolerate the acid,” he explains. “That change is called metaplasia, or Barrett’s esophagus.”

This cellular transformation increases the risk of further mutations. If the process continues unchecked, it can advance to dysplasia, the final stage before esophageal cancer develops. Gioffre emphasizes that addressing reflux at its root cause is essential to preventing this progression of cellular changes.

Men appear particularly vulnerable to these risks due to several factors. They typically deplete magnesium faster, tend to carry more visceral fat that pushes upward on the stomach, consume heavier meals and are more likely to eat late at night. These habits weaken the lower esophageal sphincter and disrupt normal digestive processes.

“Eating within three hours of lying down almost guarantees the stomach does not empty, and that is one of the biggest drivers of nighttime reflux,” Gioffre warns. Men also typically ignore symptoms longer or mask them with medications rather than addressing underlying causes.

Several warning signs indicate when acid reflux has progressed from an occasional problem to a chronic condition requiring medical attention. These include increasing frequency or intensity of heartburn, difficulty swallowing, feeling that food is stuck in the throat, persistent hoarseness, chronic cough, frequent throat clearing and the sensation of a lump in the throat.

“Ulcers in your throat, or even in your mouth, are another sign that the acid is doing real damage,” Gioffre cautions. “Another major warning sign is when reflux goes from something you notice occasionally to something you feel every day or every night, or when PPIs and antacids stop helping.”

Nighttime reflux represents a particularly serious concern because acid can remain in contact with esophageal tissue for hours while lying down, potentially causing significant inflammation and cellular changes. More alarming symptoms such as unexplained weight loss, vomiting blood, or black stools warrant immediate medical evaluation.

To protect against reflux-related complications, Gioffre recommends three key preventive strategies. First, stop eating at least three hours before bedtime to ensure the stomach empties properly before lying down. Second, strengthen the lower esophageal sphincter by consuming magnesium-rich foods like avocados, spinach, pumpkin seeds and quinoa, possibly supplemented with magnesium supplements. Finally, eliminate or reduce common trigger foods and habits that weaken the esophageal barrier, including alcohol, caffeine, chocolate, spicy foods, garlic, onions and processed foods.

By addressing these factors, individuals may prevent the progression from occasional heartburn to chronic GERD and reduce the risk of developing more serious esophageal conditions.