Millions of Americans suffer from chronic heartburn as a result of gastro-esophageal reflux disease or GERD where stomach acid refluxes back up into the esophagus. Some reflux is normal. However, when this becomes excessive and occurring too frequently it is called GERD. Normally the lower esophageal sphincter (LES) acts like a natural “valve” or barrier between the esophagus and stomach preventing reflux of stomach acid into the esophagus. When this muscle is weak, excessive reflux can occur. This can have a significant impact on an individual’s quality of life. Symptoms can include heartburn, chest pain, swallowing difficulties, regurgitation, and burning sensation in the back of the throat. If left untreated, chronic GERD can also lead to more serious conditions such as asthma/chronic cough, damage of the esophagus (esophagitis), ulceration and even cancer of the esophagus.
Medical Management & Lifestyle Changes
This is the first-line treatment option for GERD. Lifestyle changes include avoidance of trigger foods, weight loss for those who are overweight or obese, quitting smoking, raising the head of the bed, and eating smaller meals to name a few.
Various over-the-counter antacid options are available that help neutralize the acid in the stomach or decrease acid production. These include medications such as TUMS, Rolaids, Pepcid, and various Proton Pump Inhibitors (PPIs). Prescription strength PPIs can also be prescribed by your physician.
It is important to note that medications & lifestyle changes do not “cure” GERD. They are designed to control the symptoms and lessen the damage caused by stomach acid refluxing into the esophagus. They do not prevent reflux but make that reflux less acidic. Many patients experience a rapid return of their previous symptoms once medications are discontinued.
If medications and lifestyle changes do not offer relief, or if patients do not want to take medications for life and desire a longer term cure for GERD, surgery is an option. Our expert surgeons, Dr. Salameh and Dr. David, offer various surgical and endoscopic anti-reflux treatment options.
Anti-reflux surgery involves reinforcing the natural “valve” or barrier between the esophagus and the stomach. The “valve” is reinforced by wrapping the upper portion of the stomach around the lowest portion of the esophagus. This reinforcement improves the barrier function of this valve preventing excessive reflux and improving GERD symptoms. When a heat hernia is present, it is repaired at the same time (see Hiatal Hernia Surgery). The surgery is done using minimal invasive or keyhole surgery which minimal pain and a quick recovery.
This is a non-invasive, non-surgical, endoscopic procedure, that delivers radio frequency (RF) energy to the lower esophageal sphincter muscle, which is the natural valve that prevents reflux. This RF energy regenerates the tissue, resulting in improved barrier function preventing excessive reflux and improving GERD symptoms.
Our surgeons will be happy to evaluate you and customize a treatment plan that is best suited for you based on your symptoms and on objective testing at our Heartburn Center. They also welcome second opinions.