Conditions We Treat for GERD and Foregut Disorders

Some of the most common conditions we treat include:

Achalasia

Achalasia is a swallowing disorder that prevents food from flowing from the mouth to the stomach properly.

With Achalasia, muscles in the esophagus and lower esophageal sphincter (the valve that separates the esophagus from the stomach) don't work properly. Normally, when people swallow, the lower esophageal sphincter relaxes to allow food and liquid to pass into the stomach. With achalasia, that sphincter does not relax, which causes food to lodge in that area.

Achalasia often develops slowly, and while there is no cure, symptoms can be controlled with treatment. Long-standing achalasia increases the risk of esophageal cancer.

Symptoms of Achalasia

Symptoms can occur a bit differently in each person. They develop over time as the esophagus becomes wider and weaker. Symptoms can include:

• Difficulty swallowing food and liquids
• Feeling of food getting stuck in the throat or chest
• Coughing or choking during meals
• Effortless regurgitation of undigested food 
• Vomiting after or during eating
• Chest pain
• Heartburn
• Unexplained weight loss
• Bad breath
• Recurrent episodes of pneumonia

Barrett's Esophagus

Barrett's esophagus is a complication of gastroesophageal reflux disease (GERD), a condition in which the stomach regurgitates its contents into the esophagus, causing erosions in the esophagus.

With Barrett's esophagus the flat pink lining of the esophagus becomes damaged by acid reflux, causing the lining to thicken and become red.

While it is rare that someone with this disease will get cancer of the esophagus, having Barrett's esophagus may raise your risk of having esophageal cancer.

Symptoms of Barrett's Esophagus

The development of Barrett's esophagus is most often attributed to long-standing GERD, which may include these signs and symptoms:

• Frequent heartburn and regurgitation of stomach contents
• Difficulty swallowing food
• Less commonly, chest pain

Each person's symptoms may vary.  Many people with Barrett's esophagus have no symptoms.

Esophageal Cancer

Esophageal cancer is a malignant (cancerous) tumor that originates in the esophagus, the tube that transports food from your mouth to your stomach.

Symptoms of Esophageal Cancer

Esophageal cancer may have no obvious symptoms in its early stages. As the tumor grows, it narrows the opening of the esophagus. Symptoms may include:

• Difficulty swallowing
• Chest pain, pressure, or burning
• Vomiting or coughing up blood
• Heartburn
• Hoarseness or chronic cough
• Unintentional weight loss

Esophageal Diverticulum

An esophageal diverticulum is a protruding pouch in a weak area of the esophageal lining.

This pocket-like structure can appear anywhere in the esophageal lining between the throat and stomach.

Esophageal diverticula (pleural of diverticulum) are classified by their location within the esophagus:

• Zenker's diverticula - the most common type of diverticula of the esophagus, Zenker's diverticula are usually located in the back of the throat, at the top of the esophagus
• Midthoracic diverticula - occurs in the middle part of the esophagus in the mid-chest
• Epiphrenic diverticula - located in the lower part of the esophagus, above the diaphragm

Symptoms of Esophageal Diverticulum

Esophageal diverticulum don't always cause problems. When they do, the symptoms tend to come on slowly as the pouch grows.

The symptoms of esophageal diverticula may include:

• Difficulty swallowing
• Feeling of food caught in the throat
• Pulmonary aspiration (the entry of food into the breathing passages and lungs)
• Regurgitation of stomach contents
• Pain when swallowing
• Hoarseness or chronic cough
• Neck pain
• Unexplained weight loss
• Bad breath (halitosis)
• Boyce's sign - a gurgling sound as air passes through the diverticulum
• Recurrent episodes of pneumonia

Gastroparesis

Gastroparesis is a disease of the muscles of the stomach that causes the muscles to stop working. This results in inadequate grinding of food by the stomach, and poor emptying of food from the stomach into the intestine.

Gastroparesis can be due to a variety of issues and is a common condition in people who have had diabetes for a long time.

There's no known cure for gastroparesis, but medical treatment can help you manage your symptoms.

Symptoms of Gastroparesis

The symptoms of gastroparesis can range from mild to severe. They occur more often in some people than others and can include:

• Upper abdominal pain
• Nausea
• Vomiting
• Loss of appetite
• Bloating
• Feeling full quickly when eating
• Unexplained weight loss

GERD

Gastroesophageal reflux disease (GERD) is a common condition that occurs when stomach acid flows backward into the esophagus. This "reflux" can irritate the esophagus, causing heartburn, pain, and discomfort in the chest. In some cases, acid reflux can cause upper and lower respiratory tract symptoms. Longstanding GERD has been linked to Barrett's esophagus, which puts the patients at higher risk for esophageal cancer than the general population. Therefore, treating GERD early is very important for both symptom management and decreasing the risk of developing precancerous and cancerous conditions of the esophagus.

GERD often occurs in patients with a weak lower esophageal sphincter, the valve that separates the esophagus from the stomach.

Symptoms of GERD

Although GERD is not life-threatening, it can cause intense pain, interfere with eating and swallowing, and result in changes, erosions, and scarring in the esophagus. Common symptoms include:

• Recurring heartburn, especially after meals
• Hoarseness or sore throat
• Laryngitis
• Chronic dry cough, especially at night
• A feeling of a lump in your throat
• Bad breath
• Chest pain or discomfort
• Difficulty swallowing

It is possible, however, to have GERD without noticeable symptoms.

Hiatal Hernia

A hiatal hernia is a condition in which the upper part of your stomach bulges through an opening in your diaphragm (the large muscle separating your abdomen and chest). Your diaphragm helps keep acid from coming up into your esophagus.

Symptoms of a Hiatal Hernia

Most small hiatal hernias cause no signs or symptoms. But larger hiatal hernias can cause:

• Heartburn
• Regurgitation of stomach contents
• Difficulty swallowing
• Chest or abdominal pain
• Shortness of breath
• Vomiting of blood or passing of black stools
• Feeling full quickly when eating

Paraesophageal Hernia

Paraesophageal hernias are a type of hiatal hernia that occurs when part of your stomach pushes up through the opening of the diaphragm (the large muscle separating your abdomen and chest) into your chest and alongside the esophagus. This type of hernia is less common but can be more serious.

Symptoms of a Paraesophageal Hernia

For many patients, a paraesophageal hernia may not cause any symptoms and therefore, can often go unnoticed. However, once symptoms present themselves, this may indicate that the hernia is progressing. Common symptoms may include:

• Chest pain
• Upper abdominal pain
• Difficulty swallowing
• Regurgitation of stomach contents
• Shortness of breath
• Vomiting of blood or passing of black stools
• Feeling full quickly when eating