Our practice specializes in the latest and most advanced treatment for reflux including medical, endoscopic and surgical treatment options.

What is GERD?

Gastroesophageal reflux disease (GERD) is the chronic backflow of stomach contents into the esophagus. While the tissue lining of the stomach is able to handle digestive agents such as acid, the lining of the esophagus is not. As a consequence, when stomach contents back up into the esophagus, it can cause a burning sensation commonly referred to as heartburn, the hallmark symptom of GERD. In addition to heartburn, other symptoms associated with GERD include regurgitation, chest pain, hoarseness, wheezing, and chronic cough.

GERD is often due to a weakening of the tissues that make up the valve like barrier between the esophagus and stomach (also known as the gastroesophageal junction). Most patients exhibiting GERD have an abnormal function of this valve, allowing stomach contents to flow freely into the esophagus. Problems with the valve function may include opening at inappropriate times, having a lower than normal pressure, or it may be displaced into the chest (hiatal hernia).

Left untreated, GERD can lead to a variety of serious esophageal complications including inflammation (also known as esophagitis), ulceration, or strictures. In addition, GERD patients are at risk to develop a pre-cancerous condition known as Barrett’s esophagus. Studies have shown that patients with Barrett’s esophagus are more likely to develop esophageal cancer.

There are an estimated 15 million GERD sufferers in the U.S., making it the most prevalent disorder of the esophagus. GERD has a major impact on patient quality of life; the combination of uncomfortable symptoms, dietary restrictions and functional limitations can take a major toll on a patient’s sense of well being.

What are the Treatment Options for GERD?

A number of options are available to treat GERD including: lifestyle changes, drug treatment,
surgical treatment, and the EsophyX™ treatment.

Lifestyle Changes

Infrequent heartburn may be controlled by lifestyle modifications such as weight reduction, smoking cessation, and eating modifications. Eating smaller meals may reduce reflux since large meals increase stomach pressure which may allow contents to back up into the esophagus. Since stomach acid production is at its peak after eating, many reflux sufferers will avoid lying down for several hours following a meal. Certain foods may aggravate symptoms (such as spicy foods, coffee, and alcohol), but diet alone does not cause GERD. For patients with moderate to severe heartburn, lifestyle changes alone may not completely relieve symptoms.

Medical Treatment

Over-the-counter medications such as Tums® or Mylanta® may be appropriate for mild, infrequent heartburn. For patients with persistent symptoms, prescription medications known as proton pump inhibitors such as Nexium® or Prevacid® can provide significant relief. These drug treatments are not designed to stop the physical reflux of gastric contents, rather they reduce the production of stomach acid so that irritation of the esophagus is minimized. Patients often need to take these drugs for their entire life, since GERD symptoms will typically return once medication has been discontinued. Often, eventhough the heartburn is reduced with medication, many patients will continue to have troublesome regurgitation of food and fluid into the esophagus and throat.

Surgical Treatment

Anti-reflux surgery, performed through laparoscopic incisions in the abdominal wall, can be effective in treating the underlying mechanical defect present in GERD. The Nissen fundoplication, involves wrapping a portion of the stomach around the esophagus to reinforce the weakened valve mechanism that is present in GERD. While effective, these surgeries require general anesthesia , overnight hospitalization and a recovery period lasting several days.

To view a video of the surgery visit: http://www.or-live.com/tgh/1332/

Endoscopic Treatment with the EsophyX™

Over the last several years there has been considerable interest and research in the area of endocsopic (use of a scope placed into the stomach through the mouth) treatment for reflux in order to avoid surgery. Several devices have been tired, however the EsophyX™ is currently the only one still in use.

The EsophyX™ Procedure is a flexible device that is introduced through the mouth and into the stomach similar to a routine endoscopy. The EsophyX™ tightens the muscular valve between the stomach and the esophagus, thus restoring the body’s natural barrier mechanism to gastric reflux. Patients are treated on an outpatient basis and are typically able to return to normal activities the following day.

Visit the EsophyX™ website for more information and a video about the procedure Click here