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.
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.
- LINX® Reflux Management System
LINX is a small flexible ring of magnets that opens to allow food and liquid down, then closes to prevent stomach contents from moving up. Unlike other procedures, LINX requires no alteration to the stomach, reduces gas and bloating and preserves the ability to belch and vomit. While designed to be a lifelong treatment, LINX can be removed using a minimally invasive procedure that generally lasts less than an hour. Moreover, it doesn’t limit your future treatment options.
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 330.761.1111.
