About Reflux & Swallowing Disorders
Summa Health medical and surgical specialists focus on diagnosing and treating a broad array of swallowing issues, from acid reflux, Gastroesophageal Reflux Disease (GERD) and heartburn to dysphagia (difficulty swallowing) and esophageal cancers. In fact, we've been recognized by the U.S. News & World Report as one of the top-performing hospitals in the specialties of endocrinology (diabetes care) and gastroenterology.
- Difference Between the Conditions
- Symptoms
Diagnosis - Treatment
Difference Between Acid Reflux, GERD and Heartburn
While the terms acid reflux, GERD and heartburn are often used interchangeably, they actually have different meanings:
- Acid reflux is a common medical condition that ranges in severity, from mild to serious.
- GERD is the chronic form of acid reflux, occurring more than twice a week or causing inflammation in the esophagus.
- Heartburn is a symptom of acid reflux and GERD.
Symptoms of Acid Reflux, GERD and Swallowing Disorders
Some signs and symptoms of acid reflux, GERD and swallowing disorders may include
- A bitter, sour or acid taste in your mouth
- Excessive burping, belching and/or bloating
- Regurgitation
- Extra effort needed to chew or swallow
- Coughing during or immediately after eating or drinking
- Feeling like food is “sticking” in your chest or throat
Please note that chest pain caused by acid reflux and GERD may feel similar to that caused by heart problems. Be sure to have any chest pain evaluated by your doctor.
Diagnosis of Acid Reflux, GERD and Swallowing Disorders
Since symptoms can vary in severity and frequency, Summa Health medical and surgical specialists perform a comprehensive evaluation using various diagnostic tools, like:
- Esophagogastroduodenoscopy (EGD), a procedure to examine the lining of your esophagus, stomach and small intestine
- Modified barium swallow test, a procedure designed to determine whether food or liquid is entering your lungs
- Esophageal pH monitoring, a test that measures how often stomach acid enters the esophagus
- High-resolution esophageal manometry, a test to measure the strength and muscle coordination of your esophagus when you swallow
- Treatment of Acid Reflux, GERD and Swallowing Disorders
After an evaluation of esophageal function, we’ll create an individualized treatment plan based on the type and severity of your condition and how it’s affecting your day-to-day functionality. Typical treatment options include:
- Lifestyle changes like eating smaller, more frequent meals or reducing fatty food intake
- Medical management using proton pump inhibitor (PPI) medications, such as omeprazole, that reduce stomach acid and overcome esophagus spasms
- Minimally invasive surgery like Laparoscopic Nissen Fundoplication
If you are experiencing symptoms of acid reflux, GERD or a swallowing disorder, talk to your doctor or schedule an appointment with the Summa Health medical and surgical specialists at 888.906.2132.
Gastroesophageal Reflux (GERD)
Gastroesophageal reflux disease (GERD) occurs when the esophagus is exposed to prolonged periods of stomach acid. A defective lower esophageal sphincter is responsible for most cases of reflux. The lower esophageal sphincter (LES) is a high-pressure zone near the junction of the stomach and esophagus. Normally, the LES acts like a valve closing after swallowing. In patients suffering with GERD, the LES fails to close adequately, which allows the esophagus to be exposed to acid. Heartburn, esophagitis, esophageal stricture and even cancer may result.
- Symptoms
- Causes
- Treatment
GERD Symptoms
Symptoms associated with GERD vary, but generally include:
- Heartburn – 30-60 minutes after eating
- Regurgitation – worsened with lying flat
- Excessive belching
- Aspiration – stomach contents refluxed into the airway
- Asthma – chronic result of aspiration
- Chest pain – burning mid-chest pain
- Difficulty swallowing
- Pain with swallowing
- Bleeding
Chest pain caused by GERD may feel similar to that caused by heart problems. Be sure to have chest pain evaluated by your doctor.
Causes of GERD
Certain factors can make GERD more likely, such as:
- Overweight/obesity
- Hiatal hernia
- Pregnancy
- Certain types of food/drink, such as caffeine, alcohol and fatty/greasy foods
- Certain medications
- Smoking/tobacco use
Treatment of GERD
The Summa Health Digestive/Gastroenterology team offers various treatments for GERD, including lifestyle changes, medical management and minimally invasive surgery.
Lifestyle changes typically include:
- Weight loss
- Smoking cessation
- Reduced fatty food intake
- Reduced consumption of caffeinated and carbonated beverages
- Elevation of the head of the bed during sleeping
- No oral intake four to six hours prior to going to sleep
Medical management may include:
- Over-the-counter antacids/H2 blockers (stomach acid production blockers)
- Proton pump inhibitors (stomach acid production blockers)
- Stomach motility agents (quicker stomach emptying and decrease LES pressure)
- Stomach lining coating agents (protects healing portions of the stomach)
Minimally invasive surgical options include:
- Laparoscopic Nissen Fundoplication
During Nissen fundoplication, the surgeon wraps the top of the stomach around the lower esophagus. This reinforces the lower esophageal muscle or sphincter, making it less likely that acid will back up into the esophagus. The procedure typically lasts up to one and a half hours. Patients are started on clear liquids the next morning and discharged in the afternoon.
If you are experiencing symptoms of GERD or another swallowing disorder, talk to your doctor. To schedule an appointment to discuss your condition with Summa Health medical and surgical specialists, call us at 888.976.9051.
Heartburn
Many people experience heartburn and acid reflux, or GERD, at some point in their lives. In fact, gastrointestinal, or GI, diagnoses affect a substantial portion of the general U.S. population, and GI-related conditions are a considerable source of morbidity, mortality and cost within the U.S.
Symptoms of Heartburn
The most common symptom is an uncomfortable or painful “burning” sensation or pressure in your chest, just behind the breastbone. The pain may worsen after eating or when lying down or bending over, and it can last minutes or continue for a few hours. Other common symptoms include:
- Feeling like food is “sticking” in your chest or throat
- A bitter, sour or acid taste in your mouth
- Discomfort that gets worse after eating
- Burping and/or bloating
Heartburn Complications
It's important to see a doctor about your symptoms because, left untreated, the harsh stomach acids that leak into the esophagus may cause tissue damage over time. In fact, Barrett’s esophagus is a disorder in which the lining of the esophagus is damaged by stomach acid. People who have had reflux for a long time are more likely to have this condition. People with Barrett’s esophagus have an increased risk for esophageal cancer.
Non-Surgical Treatment for Heartburn
Most people can manage the discomfort of heartburn with lifestyle changes, weight loss and medications, including Proton Pump Inhibitors, or PPIs. PPIs reduce the amount of stomach acid made by glands in the lining of the stomach. They include over-the-counter medications, as well as omeprazole. While common, these medications are not without risk. Short-term use can result in headache, diarrhea, constipation and abdominal pain. Recent studies point to long-term effects, such as increased risk of pneumonia and bone fractures.
Surgical Treatment for Heartburn
Sometimes a surgical approach may be necessary to alleviate symptoms. If surgery is required, Summa Health patients have access to the latest technology and surgical techniques. A surgical option is Laparoscopic Nissen Fundoplication. During Nissen fundoplication, the surgeon wraps the top of the stomach around the lower esophagus. This reinforces the lower esophageal muscle or sphincter, making it less likely that acid will back up into the esophagus. The procedure typically lasts up to one and a half hours. Patients are started on clear liquids the next morning and discharged in the afternoon.
If you are experiencing regular symptoms of heartburn or another swallowing disorder, talk to your doctor. To discuss your condition with Summa Health medical and surgical specialists, schedule an appointment at 888.494.2602.
Laparoscopic Nissen Fundoplication
During Nissen fundoplication, the surgeon wraps the top of the stomach around the lower esophagus. This reinforces the lower esophageal muscle or sphincter, making it less likely that acid will back up into the esophagus. The procedure typically lasts up to one and a half hours. Patients are started on clear liquids the next morning and discharged in the afternoon.
If you are experiencing regular symptoms of heartburn or another swallowing disorder, talk to your doctor. To discuss your condition with Summa Health medical and surgical specialists, schedule an appointment at 888.494.2602.
Laparoscopic Nissen Fundoplication
Surgery for Gastroesophageal Reflux Disease (GERD) may involve a procedure to reinforce the lower esophageal sphincter known as laparoscopic Nissen fundoplication.
- Procedure
- Benefits
- Other Treatment Options
Laparoscopic Nissen Fundoplication Procedure
A minimally invasive surgery, laparoscopic Nissen fundoplication is performed through five quarter-inch incisions through which a camera and four instruments are placed. A new lower esophageal valve is constructed by wrapping a two-centimeter portion of the stomach around the lower-most portion of the esophagus. This collar is then anchored to the tough fibers of the diaphragm (the respiratory muscle separating the chest from the abdomen). The procedure typically lasts from forty-five minutes to one-and-a-half hours.
Benefits of Nissen Fundoplication
Laparoscopic Nissen fundoplication patients are started on clear liquids the morning after the procedure and discharged in the afternoon. They can return to activities within 2-7 days report less frequent wound infections and less pain. Most importantly, greater than 90% of patients are symptom-free 10 years after the procedure.
Other Treatment Options
Laparoscopic Nissen fundoplication is a viable option for GERD treatment after failure of lifestyle changes, sufficient attempts at medical management, or prolonged medical management.
Discuss with your doctor the many treatment options available for GERD and other swallowing disorders. To schedule an appointment with our Summa Health medical and surgical specialists, call 888.976.9051.