Also known as acid reflux disease, GERD’s common symptoms include heartburn (the most common symptom), regurgitation, belching, hoarseness, sore throat, persistent cough and bloating and burning in the mouth or throat.
Prolonged acid reflux can cause chronic inflammation of the esophagus and a change in its lining known as Barrett’s esophagus. This can contribute to cancer of the esophagus.
The esophagus is the tube connecting the mouth with the stomach. GERD results when stomach acid or intestinal bile backs up into the esophagus from the stomach. This happens when the antireflux barrier valve fails to close completely. Normally this valve closes after allowing food to pass into the stomach. When this closure fails, stomach acid or intestinal bile can reflux out of the stomach. The valve tends to fail because of excessive weight, diet, aging or stomach injuries.
Pharmaceuticals are the most common treatment option. Diet and lifestyle changes also can help bring relief. Sleeping in an upright position can reduce nighttime reflux. The underlying anatomical problem will remain, however, despite these treatments. Even with medications, you might still need to restrict your diet.
While long-term relief has been available through laparoscopic surgery, a new surgical technique called transoral incisionless fundoplication (TIF) requires no incisions and relieves acid reflux.
The new technique is described as “surgery from within.” With the patient under general anesthesia, the surgeon inserts a device known as the EsophyX through the mouth (transorally) and lowers it toward the stomach. A camera in the device enables the surgeon to see the operating site.
The surgeon then manipulates the device to make and fasten several tissue folds, known as plications. This creates an antireflux valve at the junction of the stomach and esophagus.
Most patients go home the next day and can return to work and most normal activities within a few days. In the weeks following surgery, a natural healing process fuses and cements the plications to create a durable antireflux barrier. The patient has no visible scarring and less pain than with laparoscopy.
While over-the-counter antacids and prescription medications such as proton pump inhibitors (PPIs) relieve the symptoms of acid reflux, the TIF procedure provides an anatomical solution to the underlying anatomical problem.
To gauge whether you should seek medical help for acid reflux, take this self-assessment. Think about the severity and frequency with which you have had any of these problems.
Within the past 12 months, have you experienced any of the following symptoms: heartburn, chest burn, coughing, voice transformation, hoarseness, uncomfortable feelings radiating from the chest to the throat or constant earache or sinusitis?
Within the past 12 months, have you ever had gastric acid reflux?
Within the past 12 months, have you ever had gastric acid reflux coming to your throat?
In the past 12 months, how many times did you take antacids or other medicines for stomach ailments?
Fortunately, you can find help not far from home. Northern Nevada Medical Center now offers a Heartburn and Reflux Center dedicated to treating GERD and other digestive problems. To schedule a consultation, call 356-4980.
Michael Murray, MD, FACS, is board certified in general, breast and endoscopic surgery. He graduated with his medical degree from Hahnemann School of Medicine, in Philadelphia, Penn., in 1988. He completed his residency in general surgery at the Medical College of Pennsylvania and his internship at Allegheny General Hospital in Pittsburgh, Penn.
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