Heartburn and reflux

Gastroesophageal reflux disease (GERD) consists of heartburn and acid reflux occurrences that happen at least three times a week and cannot be treated through dietary and other lifestyle changes. Patients with GERD have a damaged lower esophageal sphincter (LES) — the valve that closes the esophagus off from the stomach.

When the esophageal sphincter malfunctions, the valve cannot work properly and lets highly acidic digestive juices rise up into the esophagus, resulting in the symptoms of heartburn and acid reflux.

Unfortunately, if left untreated, serious complications can occur, including inflammation, ulcers and cancer in the esophagus.

What causes GERD?

Some factors that contribute to GERD are:

• Being overweight or obese
• Consuming citrus fruits, tomatoes, coffee, alcohol, spicy foods, fatty foods or carbonated drinks
• Having a hiatal hernia
• Lying down after eating a heavy meal
• Being pregnant
• Smoking

What are the symptoms of GERD?

Symptoms of GERD include:

• Difficulty swallowing (dysphagia)
• Dry cough
• Heartburn and chest discomfort
• Hoarseness, often in the morning
• Sensation of food stuck in the throat

Long-term and untreated GERD can lead to Barrett's esophagus, a condition where the lining of the lower esophagus becomes damaged by acid reflux. Patients with Barrett's esophagus have a higher risk of cancer of the esophagus.

For this reason, we encourage you to come see us if you think you may have GERD or chronic acid reflux. Earlier diagnosis and treatment can help you prevent cancer and other long-term problems caused by these conditions.

Dysphagia is the medical term for swallowing difficulties. This may start with difficulties swallowing certain foods. You may notice solid foods, like bread or meat, get stuck in the throat or lower down on the way to your stomach.

Often compensated by drinking more water or replacing solid diets with semi-solid or liquid diets, difficulty with swallowing might worsen over time.

What causes dysphagia?

Dysphagia can be caused by or related to a variety of conditions, including:

• Achalasia — condition leading to backup of food in esophagus
• Esophageal stricture — narrowing of the esophagus
• Esophageal tumor
• Eosinophilic esophagitis — chronic inflammation of esophagus
• GERD
• Radiation therapy

What are the symptoms of dysphagia?

Some signs you may want to speak with your doctor about dysphagia are:

• Continuously drooling saliva
• Coughing or choking when eating or drinking
• Difficulty swallowing, especially certain foods or liquids
• Feeling like food is stuck in your throat or lower down
• Over time, weight loss and repeated chest infections
• Regurgitating food back into the mouth or nose after swallowing

Some methods we may use to diagnose GERD and dysphasia are:

• Endoscopy — offers visible evaluation of the upper digestive tract which includes the esophagus and stomach
• Manometry — measures function, tone and muscle movement of the esophagus and esophageal sphincters (valves)
• PH testing — measures the frequency and duration of the stomach acid traveling back into the esophagus
• Radiological and imaging modalities such as barium X-rays, computerized tomography (CT) scans and magnetic resonance imaging (MRI)

Our team of gastroenterologists and esophageal specialists offers individualized treatment options for acid reflux, GERD and dysphagia, depending on the stage and severity of your symptoms.

Some treatments we can help you with or provide include:

• Diet modification (changing eating habits)
• Lifestyle modifications, such as elevating the upper body when lying down
• Medications for symptom management
• Minimally invasive laparoscopic and robot-assisted surgical procedures to restore the proper function of the esophageal sphincter