For most people, heartburn is an occasional annoyance and source of temporary discomfort. But for some, chronic heartburn can lead to more dangerous conditions — potentially even pre-cancerous ones.
About 10% of people with chronic gastroesophageal reflux disease (GERD) will develop Barrett’s esophagus, a condition where the lining of the lower esophagus is replaced with abnormal cells that are more prone to cancer, according to medical experts.
Some studies have shown that among those with Barrett’s esophagus, between 3% and 13% will go on to develop cancer, but most will not.
When acid reflux becomes dangerous
“Your stomach is designed to handle acid. Your esophagus is not,” Dr. Daryl Gioffre, a Florida-based gut health specialist and certified nutritionist, told Fox News Digital.
“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 most people, the lower esophageal sphincter — which Gioffre refers to as the “acid gate” — keeps acid in the stomach, which is lined with thick mucus and specialized cells designed to protect it.
“But when the gate gets weak, it relaxes or stays slightly open, and acid slips back up the wrong way,” he said. This “gate” can weaken with magnesium deficiency, high stress, alcohol, poor sleep, dehydration and late-night snacking, all of which can disrupt healthy digestion.
When acid hits the esophagus, it irritates tissue that was never designed to withstand it, according to the doctor.
“Every time acid comes back up the wrong way, it injures the lining like a slow chemical burn,” said Gioffre, who is also the author of “Get Off Your Acid” and “Get Off Your Sugar.” Over time, that irritation erodes the lining, drives inflammation and can change the cells.
“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,” the doctor said. “That change is called metaplasia, or Barrett’s esophagus.”
Once the cells start changing, the risk of further mutation goes up. If that process continues, Gioffre warned, it can progress to dysplasia, which is the stage right before esophageal cancer.
“So the real danger is not the heartburn you feel,” he summarized. “It is the repeated acid exposure forcing the esophagus to adapt in ways it was never designed to. Fixing reflux at the root stops this entire cascade before those cellular changes begin.”
Men at higher risk
Men generally have a higher risk because they burn through magnesium faster, tend to carry more visceral fat pushing upward on the stomach, eat heavier meals and snack late at night, Gioffre cautioned. These activities all weaken the acid gate and shut down healthy digestion.
“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,” he said. “On top of that, men often ignore symptoms, or mask them with PPIs and antacids instead of fixing the root cause.”
All of these factors contribute to a “perfect storm” for chronic inflammation and long-term damage, according to Gioffre.
Warning signs
There are certain red flags that indicate when acid reflux has gone beyond an occasional annoyance and has progressed to constant and chronic.
“If that burn becomes more frequent or more intense, or starts showing up even when you have not eaten, your body is waving a giant warning flag,” Gioffre said.
Difficulty swallowing, a feeling that food is “stuck,” chronic hoarseness, a constant cough, throat clearing or the feeling of a lump in the throat are all indicators that the acid is moving upward into areas it should never reach, according to the doctor.
“Ulcers in your throat, or even in your mouth, are another sign that the acid is doing real damage,” he warned.
“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,” Gioffre said. “That usually means the lining is irritated and eroded, and may already be changing on a cellular level.”
Unexplained weight loss, vomiting blood and black stools are all serious symptoms that demand immediate attention, the doctor added.
“The bottom line: When reflux becomes consistent, chronic and starts impacting swallowing, your voice, or the tissues in your mouth or throat, it is no longer just a nuisance,” Gioffre told Fox News Digital. “That is the point where the esophagus may be moving toward a precancerous state, and men especially cannot afford to wait on it.”
3 key ways to prevent reflux
Gioffre shared the following essential steps to preventing acid reflux and improving digestive health.
No. 1: Follow the 3-hour rule
“Stop eating three hours before bed,” the doctor recommends. “When you eat late, the stomach does not empty, pressure builds and the acid gate relaxes, guaranteeing that acid travels upward into your esophagus while you sleep.”
Nighttime reflux is the most dangerous because the acid sits on the esophagus for hours, causing deep inflammation and long-term cellular changes, he warned. “This one rule alone can dramatically lower acid reflux and cancer risk.”
No. 2: Strengthen the acid gate
When stomach acid is low, the lower esophageal sphincter loses its tone, allowing acid to travel upward instead of staying in the stomach, Gioffre said.
“The fastest way to tighten that gate is to build your mineral reserves, especially magnesium,” he said.
The best way to do this is to load up on magnesium-rich foods like avocado, spinach, pumpkin seeds, chia seeds, quinoa and almonds, and consider adding a clean magnesium supplement.
No. 3: Remove or neutralize daily triggers
The fastest way to protect your esophagus, according to Gioffre, is to eliminate or neutralize the foods and habits that weaken the acid gate and push acid the wrong way.
For people who can’t fully eliminate these triggers, certain habits can help neutralize their impact by reducing acid strength and pressure before it reaches the esophagus.
“Drinking most of your water earlier in the day helps, because pounding water at night stretches the stomach and relaxes the acid gate, making it much easier for acid to flow the wrong way once you lie down,” he said.
He also recommends cutting back on alcohol and caffeine, both of which relax the acid gate instantly.
Some other major triggers that fuel the reflux cycle include chocolate, spicy foods, garlic, onions, sugar, ultraprocessed foods and heavy nighttime meals, according to the doctor.
“These foods and habits weaken the lower esophageal sphincter, drive up inflammation and push pressure upward,” he said. “That’s exactly how a little heartburn turns into chronic reflux, and slowly causes the kind of damage that puts the esophagus at risk for cancer.”
