Reflux

There's more to heartburn than just a little discomfort.

We specialize in the diagnosis and treatment of gastroesophageal reflux disease (GERD). Using the most advanced technology and treatment options, we are able to develop a reflux care pathway specific to you and your needs.

What is GERD?

Lower Esophageal Sphincter and Reflux​Gastroesophageal reflux disease (GERD) can present itself in many ways: heartburn, regurgitation, cough, hoarseness, sore throat or respiratory complications. But all reflux is due to a failure of the valve that separates your esophagus from your stomach, the Lower Esophageal Sphincter (LES).

Left untreated, GERD can lead to:

  • Inflammation of the esophagus
  • Narrowing of the esophagus
  • Open sores in the esophagus
  • Precancerous changes

Coping with GERD can lead people to restrict their diet, change sleeping patterns, miss work and stop activities that they enjoy. 

Evaluation

Getting a proper diagnosis of your reflux and its progression is very important. We have advanced technology allowing us to perform the following tests in order to assess your situation:

Esophagogastroduodenoscopy (EGD)
Evaluates the inside lining of the esophagus and stomach looking for sores, inflammation, precancerous or even cancerous changes.

Esophageal pH and Impedence Testing
Determines the frequency and severity of reflux episodes and determines if your symptoms are related to reflux events.

Manometry/Motility
Measures the function and coordination of swallowing muscles in the esophagus.

Esophagram
Visualizes the anatomy of the esophagus and stomach in relation to other structures.

Gastric Emptying Study
Measures how quickly food in the stomach empties into the small intestine.

Pharyngeal pH Testing (Restech)
Determines the frequency and severity of reflux episodes in the throat.

Completing these tests will give you and your doctor the information necessary to determine the best care pathway.

Treatment Options

Lifestyle Changes
Before seeking surgical options, adjusting lifestyle changes may alleviate and control GERD symptoms.

Avoid trigger foods

  • Caffeine
  • Alcohol
  • Nicotine
  • Peppermint, chocolate
  • Acidic, fatty or spicy foods
  • Excessive NSAID use

Avoid excess pressure in the stomach

  • Lose weight
  • Avoid eating three hrs before bedtime
  • Elevate the head of your bed
  • Eat smaller meals

Medical Treatment Options
Decrease the acidity of stomach contents

  • Antacids
  • H2 blockers
  • Proton Pump Inhibitors (PPIs)

It is important to know that medications do not stop reflux events, they only make the reflux less acidic. Patients should also understand that long term use of some antacid medications can be detrimental to your health.

Surgical Treatment Options

Despite the above steps, some people still suffer from reflux symptoms which affect quality of life. In those cases, surgery can help.

Transoral Incisionless Fundoplication (TIF)
Using a special device that is inserted through the mouth while you are sedated, the esophagus is pulled further into the abdominal cavity and the stomach is gently plicated (folded) onto the esophagus. This recreates the Lower Esophageal Sphincter to prevent reflux.

  • No incisions mean quicker recovery and a lower risk profile
  • Allows normal belching and vomiting
  • 75% of patients are off PPIs after the procedure
  • 90% of regurgitation symptoms are resolved
  • Provides consistent and reliable outcomes
  • Reversible if necessary

TIF procedure

Magnetic Augmentation
A small device is placed around the esophagus. This device uses magnetic attraction to support the LES and prevent reflux without changing your body’s natural anatomy.

  • Allows easy passage of food
  • Allows normal belching and vomiting
  • 90 percent of patients are still off their antacid medications five years after surgery
  • Should not be used in patients with metal allergies

LINX procedure

Fundoplication (Nissen Fundoplication Surgery)
Part of the stomach is loosely wrapped around the esophagus. This augments the LES valve to prevent reflux.

  • Some patients have difficulty belching and vomiting through the wrap
  • No implantation of foreign body
  • Best results seen in patients with Body Mass Index (BMI) less than 35

Nissen Fundoplication procedure

Gastric Exclusion
Divides the portion of the stomach that produces acid and diverts it away from the esophagus.

  • Best in patients with a Body Mass Index (BMI) greater than 35
  • Will result in loss of excess weight
  • Can result in vitamin and mineral deficiencies

Gastric Exclusion procedure