Travis from Katy sent us this question: “I have Barrett’s esophagus. I do intermittent fasting, but I notice that in the periods I don’t eat I get a burning sensation, why is that? Thank you.”
Dear Travis,
Barrett esophagus indicates stage 4 GERD. Patients with stage 4 GERD have a very weak or no acid reflux barrier. Since acid is always present in the stomach, stage 4 GERD patients experience acid reflux related symptoms independent of food intake.
Acid reflux is a direct consequence of a weak anti-reflux barrier. It is a common misconception to attribute acid reflux to food intake. In the presence of a competent anti-reflux barrier, heartburn and food regurgitation don’t occur whether you feast or fast.
The treatment for stage 4 GERD relies on re-establishing the anti-reflux barrier. The most reliable solution for stage 4 GERD is Nissen fundoplication and hiatal hernia repair.
Nissen fundoplication and hiatal hernia repair, when properly performed, stops all reflux from stomach into esophagus. Surgery success rate is 100% in properly diagnosed patients. Complication rate is less than 1%. Recovery is fast because surgery is done through tiny incisions resulting in little pain and discomfort.