Gastroesophageal Reflux Disease; referred to as GERD, is defined as a condition caused by the reflux of stomach contents into the esophagus, causing troublesome symptoms and complications. GERD is often referred to as acid reflux. They describe the same disease.
GERD Causes – GERD Symptoms – GERD Treatments
- GERD causes can be a damaged lower esophageal sphincter (LES), and overeating.
- Heartburn is the most common of GERD symptoms, but there are many others.
- Medications do not fix a damaged LES valve; minimally invasive surgical GERD treatments do.
- Our Center was selected as one of the first places in the U.S. to offer the revolutionary new LINX Reflux Management System.
What causes GERD is the malfunction of a muscular structure called the lower esophageal sphincter (LES) located at the end of the swallowing tube (esophagus) at the point where it joins the stomach. Under normal circumstances, the LES functions as a valve allowing food to pass readily into the stomach while not allowing stomach contents to back up or “reflux” upward into the esophagus. When the function of the LES is compromised, it loses its valve function and stomach contents can move the wrong direction up into the esophagus. The lining of the esophagus is sensitive and not meant to withstand exposure stomach to juices, including acid. It is easily irritated causing many symptoms, the most common of which is heartburn.
Over-eating is the major factor that causes the LES to become damaged. Filling up, or stretching of the stomach allows the LES to be exposed to stomach contents, including acid, which damages the LES. The reason the term “acid” reflux is used is that when reflux occurs, acid is the component of the stomach juice that causes most of the irritation of the esophagus. There are many other chemicals contained in the refluxing stomach contents, but it is the acid that causes most of the symptoms.
Heartburn is the most common of GERD symptoms. Heartburn is described as a burning sensation in the upper abdomen extending up into the chest under the breastbone. There can also be a pressure sensation associated with it.
Along with heartburn, the other “typical” GERD symptoms are regurgitation and swallowing difficulty, termed dysphagia. Regurgitation is the reflux of bitter stomach juice into the back of the throat without warning. This tends to occur at night, with a person waking up with bitter material in the back of the throat, accompanied by a choking sensation. It is quite a miserable experience and is very specific for acid reflux. It can occur during the day as well, even when just bending over. Dysphagia is one of the GERD symptoms that must be evaluated expeditiously. It usually represents some damage to the esophagus from long-standing reflux. However, it can also represent something quite serious such as a narrowing of the esophagus from reflux or even an esophageal cancer.
GERD can also cause other symptoms that we term “atypical.” These GERD symptoms can include chronic cough, sore throat, throat clearing, voice fatigue, worsening of preexisting asthma, dental disease and others. These atypical symptoms can be difficult to recognize as caused by GERD.
The expert testing available through the Heartburn Treatment Center accurately evaluates these symptoms to determine if they are caused by GERD. Once this determination is made that you have GERD symptoms, treatment options are offered.
There are a variety of GERD treatments available. The most common treatment of GERD is taking medications to improve symptoms. There are a host of medications available both over the counter and by prescription that all function the same way. These GERD treatments either neutralize or decrease the production of stomach acid. These drugs include antacids such as Tums, H2 blockers such as Zantac and Pepcid and the most powerful acid suppressants called PPIs (Nexium, Prilosec and others.) The medications do not address the actual cause of reflux, which is the damaged LES. The reflux continues, but it no longer contains acid. This controls symptoms in most people. These medications must be taken for life and have both short and long term side effects. Since the valve is not improved, these drugs often fail and other methods are required.
Another approach to the treatment of GERD is to directly restore the function of the damaged LES. Restoring LES function can stop the reflux; eliminate symptoms as well as the need for medications. There are several procedures intended to accomplish this.
The “gold standard” to which all antireflux procedures are compared is the laparoscopic Nissen fundoplication (Nissen). This GERD treatment is a minimally invasive surgical procedure that is performed under general anesthesia through 5 small incisions 1/4 to 1/2 inches long. A slender scope (laparoscope) is inserted into the abdomen that produces a high-resolution image on a monitor, which the surgeon carefully observes as he performs the procedure through the small incisions. The procedure involves recreating a functional valve by wrapping part of the stomach around the lower esophagus at the site of the LES. The procedure takes approximately 1-2 hours and the hospital stay is usually 1 night. Most patients are back to light, “every day” activity within a week. A successful laparoscopic Nissen fundoplication stops the reflux approximately 80-85% of the time, and 90% of patients are satisfied with the procedure after 5 years. Side effects can include the inability to belch or vomit in about 30%, as well as excess gas and bloating. A small number have swallowing difficulty. The Nissen stops the reflux with greater reliability than all existing GERD treatments procedures. Experienced surgeons who perform the Nissen obtain excellent results.
The Transoral Intraluminal Fundoplication (TIF procedure) is one of the GERD treatments that are performed without incisions. Under general anesthesia a special scope passed orally into the stomach is used to place small plastic fasteners, which attempts to recreate the dysfunctional valve from the inside of the stomach. It has been available for several years and improves GERD symptoms in most patients. It does not stop the reflux but decreases medication requirements in most patients. There are few side effects. Results have been variable.
LINX Reflux Management System
The newest of GERD treatments now available is called the LINX Reflux Management System. This is performed using the same minimally invasive technique as the Nissen, however it is much less complex. A specially designed “bracelet of magnetic beads” is placed loosely around the esophagus, augmenting the damaged LES. As food passes, the magnetic beads separate allowing the food to pass and then closes thereafter, preventing reflux. The procedure takes approximately 30 minutes and the hospital stay is overnight. Full activity and a normal diet are resumed immediately. Reflux is stopped in most patients and the side effects are minimal. Presently, this procedure is only available at select centers. The Heartburn Treatment Center was selected as one of the first places in the U.S. to offer this revolutionary GERD treatment procedure.
Call the Heartburn Treatment Center today to find out more about our GERD treatments and get on the road to relief!
Getting started on the Road to Relief
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