As diseases go, for sheer incidence, heartburn is big. An estimated one-hundred-million Americans report they suffer from this modern malady at least once a month.

Most of us think of heartburn as a minor annoyance, but more serious cases have been linked to sleep disturbance, chronic cough and difficulty swallowing.

There’s an even more worrisome aspect of heartburn that is not as well-recognized. Chronic heartburn can over many years result in an aggressive form of cancer of the esophagus that carries a high mortality rate.

Though still fairly rare at fourteen-thousand cases annually, this type of cancer, known as adenocarcinoma, is five times more common than it was thirty years ago. And the trend shows no signs of slowing.

There is growing suspicion that the way heartburn is treated may play a role in the development of cancer. Acid-reducing drugs, readily available over the counter or by prescription, have become a fixture in the American medicine cabinet. Some experts fear that while these medications might effectively address the symptoms of heartburn, they may still permit and even promote tissue damage that can lead to cancer.

Rather than stop taking these drugs, physicians suggest patients should be closely monitored to ensure the underlying problem is being addressed, not just the symptoms.

A good place to start is at the dinner table, since the heartburn epidemic and the obesity epidemic are linked. It turns out the best way to take a bite out of this big problem is to think small.