Treatment Options for Heartburn, Reflux and Esophageal Disease
Michael Ebright, MD, Director of Thoracic Surgery, Director of the Heartburn, Reflux & Esophageal Specialty Center, Stamford Health
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I like hearing about my patients’ positive feedback after surgery. For example, they may be:
- Sleeping comfortably on their backs at night because they no longer have debilitating reflux
- Eating at restaurants and not feel embarrassed by their symptoms
- Living a life without medications they thought they would be on long-term
It’s my mission to help patients struggling with gastroesophageal reflux and other esophageal diseases achieve all of the above.
About GERD, Barrett’s Esophagus and Esophageal cancer
GERD (gastroesophageal reflux disease)
A chronic digestive disorder that happens when the one-way valve between the esophagus and the stomach functions poorly. This poor function allows stomach acid to flow backward into the esophagus and irritate the lining. Many people describe their symptoms as a burning pain in the chest or “heartburn.” It’s important to note, however, that occasional heartburn does not necessarily mean a person has GERD.
Repeated exposure of the esophageal lining to stomach acid results in Barrett’s esophagus, a condition in which the tissue lining the esophagus becomes more like the tissue lining the lower intestine. GERD does not always cause Barrett’s esophagus, but Barrett’s esophagus is a risk factor for esophageal cancer.
As with many cancers, early detection is key. At the Heartburn, Reflux & Esophageal Specialty Center, we have a Barrett’s esophagus registry to track patients and ensure all are following the most current screening guidelines.
What causes esophageal diseases such as GERD, Barrett’s esophagus and esophageal cancer?
The incidence of GERD (gastroesophageal reflux disease), Barrett’s esophagus, and esophageal cancer are increasing. This may be in part due to diet choices and the obesity epidemic, but not everyone with GERD is overweight.
A common cause of GERD is a hiatal hernia, which is the bulging of the stomach up through the diaphragm and into the chest. These hernias can be mild or they can be dramatic.
Esophageal cancer can be a result of chronic GERD, although only a very small percentage of patients with GERD will ever develop cancer. Esophageal cancer has other causes as well, including smoking and excessive alcohol intake.
How do I know if I have a hiatal hernia?
While hiatal hernia can cause heartburn, but it may also result in other symptoms such as a feeling of food getting stuck, feeling full early, abdominal discomfort, and iron-deficiency anemia. Sometimes anemia may be the only symptom. The easiest test to look for a hiatal hernia is a contrast esophagram, or an x-ray of the esophagus during which you drink a milkshake that contains contrast and allows the radiologist to capture accurate images.
I’ve been having symptoms of GERD for a long time. When should I see a specialist?
When medicine is no longer helping to control symptoms of GERD, or if you find yourself dependent on medications, a visit to a specialist may be helpful.
Many of these symptoms can affect quality of life:
- Dysphagia – difficulty swallowing
- Chest discomfort
Water brash – when acid mixes with excess saliva in your throat
- Reactive airway disease – a spasm that happens when the bronchial tubes become irritated
- Pneumonia – lung infection
- Intermittent obstruction – a blockage that prevents contents from passing fully through the digestive tract
- Iron-deficiency anemia of unknown cause
Consider contacting Stamford Health’s Heartburn, Reflux & Esophageal Specialty Center if you’ve been experiencing any of the above.
What are some lesser-known symptoms of esophageal diseases?
While heartburn is the most common symptom of GERD, other less known and perhaps surprising symptoms are hoarseness, reactive airway disease, recurrent pneumonia, and anemia.
Is there a surgery for acid reflux or GERD?
Yes. Laparoscopic (minimally invasive) fundoplication is a safe and durable procedure with a high success rate. This operation remains the “gold standard” surgery for GERD.
During this operation, the surgeon will wrap the upper curve of the stomach, or the fundus, around the esophagus and sew both together into place. This helps to restore the proper function of the gastroesophageal valve. Laparoscopic fundoplication generally requires a one-night hospital stay and has a very low likelihood of complications. You’ll likely be able to stop your anti-acid medications completely after the surgery.
Other surgeries for acid reflux or GERD include:
- Laparoscopic Magnetic Sphincter Augmentation
- A gentle magnetic bead ring is placed around the bottom of the esophagus.
- Transoral Incisionless Fundoplication
- A completely endoscopic procedure during which the normal valve function can be restored without surgery at all.
A specialist with experience in all types of GERD surgery will help determine which of these surgical options is right.
Treatment Options for Esophageal Diseases
We are proud to offer a wide range of safe and effective treatment options for all esophageal diseases at the Heartburn, Reflux & Esophageal Specialty Center. We have a staff of multidisciplinary physicians, nurses, coordinators, and nutritionists doing their utmost to provide our patients with the highest level of compassionate, patient-centered care.