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Thorough Diagnosis & Care for GERD

At the Center for GERD and Foregut Disorders, our goal is to treat the cause, and not just the symptoms. We offer comprehensive care, ranging from diagnostic testing to treatment and ongoing management, for a variety of esophageal, motility, and functional disorders. 

Diagnosis

Getting to the root cause of your condition is the first step toward recovery. In addition to taking a complete medical history and performing a physical examination, our physicians may perform diagnostic testing to help confirm the extent of your condition, assess any complications, or determine if the symptoms are due to more advanced disease.

Common diagnostic procedures include:

Also known as EGD (esophagogastroduodenoscopy), an Upper Endoscopy is a procedure used to view the esophagus, stomach, and upper part of the small bowel. This examination looks for signs of reflux, peptic ulcer disease, or tumors.

EGD is more accurate than x-rays for identifying inflammation, detecting abnormal growths such as ulcers, tumors, or cancer, and for examining the inside of the upper digestive system. If your gastroenterologist detects potential abnormalities in the lining of the esophagus, a biopsy can be taken for further examination.

With this procedure, a liquid barium solution is swallowed while several x-rays are taken to examine the upper digestive tract. The liquid barium temporarily coats the lining of the esophagus, stomach, and intestine, making the outline of these organs visible on the x-ray film. The x-rays show how the solution is traveling from the mouth to the esophagus and into the stomach and is performed to visualize the presence of reflux, hiatal hernia, or obstruction.

This procedure monitors the reflux of acid from the stomach into the esophagus and measures the acidity, or pH, of the solution. It is used to evaluate for GERD and to determine how medication is working to prevent acid reflux. It is also helpful in evaluating typical symptoms that do not respond to medications.

This is a test that is used to measure the function of the lower esophageal sphincter (the valve that prevents reflux, or backward flow, of gastric acid into the esophagus) and the muscles of the esophagus. This test will tell your doctor if your esophagus is able to move food to your stomach normally.

EndoFLIP is a minimally invasive medical device used to enhance current procedures such as the upper endoscopy. This technology simultaneously measures the area across the inside of a gastrointestinal organ (for example, the esophagus) and the pressure inside that organ. This helps our gastroenterologists to see a more detailed view of the organ to help find the cause of difficulty swallowing.

Treatments

Treatment for GERD and related disorders focuses on four goals:

  • Bring the symptoms under control so that the patient feels better;
  • Heal the esophagus of inflammation or injury;
  • Manage or prevent complications such as Barrett's esophagus;
  • Keep the symptoms in remission so that daily life is unaffected or minimally affected by reflux.

Lifestyle modifications are typically the first recommendation in treating esophageal disorders before trying over-the-counter medications. If you don't experience relief within a few weeks, your doctor may then recommend prescription medication, or non-surgical and surgical treatments.

For many cases of GERD and esophageal disorders, simple changes to daily life are all that is needed to treat the disease.

For this reason, your doctor may recommend:

  • Reducing or eliminating smoking and alcohol consumption
  • Dietary changes such as avoiding spicy, acidic, or fatty foods and coffee or carbonated beverages
  • Weight loss
  • Elevating your head while you sleep
  • Eating smaller meals throughout the day
  • Wearing loose fitting clothes

This step is usually reserved for those whose symptoms are not effectively treated by either lifestyle changes, medication, or non-surgical procedures. Sometimes this may be the first option if there is a physiological defect such as a hiatal hernia. Surgical treatment is usually minimally-invasive with quick recovery.

Surgeries performed may include:

  • Laparoscopic Fundoplication – This minimally-invasive procedure is the most common surgical treatment for severe heartburn, or GERD. In this procedure, the surgeon wraps the upper part of the stomach (the fundus) around the lower portion of the esophagus, reinforcing the lower esophageal sphincter so food won’t reflux back into the esophagus.
  • Laparoscopic Heller Myotomy – A minimally-invasive procedure that uses small incisions in the abdomen to open the tight lower esophageal sphincter (the valve between the esophagus and the stomach) to relieve the dysphagia (difficulty swallowing). 
  • LINX Implant – LINX is a treatment intended for patients diagnosed with GERD who continue to have symptoms even while taking medication. This laparoscopic procedure uses a ring of flexible magnets placed around the esophagus which opens to allow food and liquids in the stomach and closes to prevent acid from going back up the esophagus. No alteration of the stomach is necessary.

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