When should a patient with GERD be referred to an oncologist?

A patient with GERD should be referred to an oncologist if they exhibit Barrett’s esophagus due to the significant risk associated with this condition. Barrett’s esophagus occurs when the normal cells lining the esophagus are replaced by cells that are more resistant to acid but are also precursors to esophageal adenocarcinoma. This change is indicative of chronic damage caused by acid reflux and necessitates careful monitoring and management, often involving surveillance endoscopies to check for dysplasia or cancer development.

Detection of Barrett’s esophagus can be a critical turning point in the management of a patient with GERD. Regular monitoring and assessment are essential to catch any malignancy at its earliest and most treatable stage. For this reason, referral to an oncologist or a gastroenterologist with expertise in this area is warranted for a patient with Barrett’s esophagus, as they require specialized care and management strategies.

Other symptoms, such as difficulty swallowing, weight loss, or severe heartburn, while concerning, do not automatically indicate a diagnosis of Barrett's esophagus or imply an immediate need for oncological evaluation unless they accompany known risk factors or findings indicative of significant complications.