Gastroesophageal Reflux Disease (GERD)
What is Gastroesophageal Reflux Disease (GERD)?
Gastroesophageal reflux disease (GERD), also known as reflux, is a common digestive disorder that occurs when a muscle at the end of your esophagus does not close properly. This allows the contents of the stomach to leak back, or reflux, into the esophagus and irritate it.
Characterized by burning in the chest or throat, known as heartburn, GERD can be caused by many conditions such as hiatal hernia or lifestyle choices such as smoking.
What Causes GERD?
GERD happens when gastric acid from your stomach backs up into your food pipe (esophagus). The lower esophageal sphincter (LES), a muscle at the bottom of the esophagus, opens to let food in and closes to keep food in the stomach. When your LES relaxes too often or for too long, acid backs up into your esophagus.
Some lifestyle issues that can cause GERD include:
- Being overweight
- Overeating
- Eating foods such as citrus, chocolate, fatty foods, or spicy foods
- Caffeine consumption
- Alcohol intake
- Smoking
- Using aspirin and over-the-counter pain and fever medicines, including nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen
Some health problems that may cause heartburn include:
- Swelling of your stomach lining (gastritis)
- Painful sores (ulcers) on the lining of your stomach, esophagus, or the first part of your small intestine (duodenum)
- An allergic condition in the esophagus (eosinophilic esophagitis)
What are the Symptoms of GERD?
Heartburn, or acid indigestion, is the most common symptom of GERD and usually feels like a burning chest pain beginning behind the breastbone and moving upward to the neck and throat. Other common signs and symptoms of GERD include:
- Difficulty or pain when swallowing
- Regurgitation of food or sour liquid
- The sensation of a lump in your throat
- Nausea or vomiting
- Bad breath
- Respiratory problems
If you have nighttime acid reflux, you might also experience:
- Chronic cough
- Laryngitis
- New or worsening asthma
- Disrupted sleep
How is GERD Diagnosed?
Your physician will conduct a physical exam and ask about any symptoms you’ve been experiencing. They might use one or more of the following procedures to confirm a diagnosis or check for complications of GERD:
- Barium swallow: after drinking a barium solution, X-ray imaging is used to examine your upper digestive tract
- Upper endoscopy: a flexible tube with a tiny camera is threaded into your esophagus to analyze it and if necessary, collect a sample of tissue (biopsy)
- Esophageal manometry: a flexible tube is threaded into your esophagus to measure the strength of your esophageal muscles
- Esophageal pH monitoring: a monitor is inserted into your esophagus to learn if and when stomach acid enters it
What are the Treatment Options for GERD?
Lifestyle modifications and over-the-counter medications are typically the first lines of defense against GERD. If you don’t experience relief within a few weeks, your physician might recommend prescription medication or surgery.
Lifestyle changes may help decrease the frequency of acid reflux. These include:
- Maintaining a healthy body weight
- Quitting smoking
- Elevating the head of your bed
- Waiting at least three hours after eating before lying down
- Eating food slowly and chewing thoroughly
- Avoiding foods and drinks that trigger reflux, including fried foods, tomato sauce, alcohol, chocolate, mint, garlic, onion, and caffeine
Over-the-counter medication options include:
- Antacids that neutralize stomach acid, such as Mylanta, Rolaids, and Tums are used for quick short-term relief.
- Medications to reduce acid production known as H-2-receptor blockers — such as cimetidine (Tagamet HB) and famotidine (Pepcid AC) — don’t act as quickly as antacids, but they provide longer relief and may decrease acid production from the stomach for up to 12 hours.
- Proton pump inhibitors are medicines that block acid production and heal the esophagus. They are stronger than H-2-receptor blockers and allow time for damaged esophageal tissue to heal. Over-the-counter proton pump inhibitors include lansoprazole (Prevacid 24 HR) and omeprazole (Prilosec OTC, Zegerid OTC).
Prescription-strength treatments for GERD include:
- Prescription-strength H-2-receptor blockers
- Prescription-strength proton pump inhibitors
- Medication to strengthen the lower esophageal sphincter
Surgery and Other Procedures to Treat GERD
Your doctor may recommend surgery if your GERD symptoms don’t improve with lifestyle changes or medicines.
Fundoplication
Fundoplication is the most common surgery for GERD. In most cases, it leads to long-term reflux control.
A surgeon performs fundoplication using a minimally invasive laparoscope, a thin tube with a tiny video camera. During the operation, the top of your stomach will be sewn around your esophagus to add pressure to the lower end of your esophagus and reduce reflux. The wrapping of the top part of the stomach can be partial or complete.
The LINX Reflux Device
Unlike standard surgical treatments for GERD, the minimally invasive LINX® Reflux Management System uses a tiny bracelet of magnetic titanium beads to surround and compress the lower esophageal sphincter. This valve typically prevents stomach fluids from refluxing into the esophagus.
A ring of tiny magnetic beads is wrapped around the junction of the stomach and esophagus. The magnetic attraction between the beads is strong enough to keep the junction closed to refluxing acid but weak enough to allow food to pass through. The Linx device can be implanted using minimally invasive surgery.
Benefits of the LINX Reflux Device
The LINX procedure generally takes less than an hour. It is performed laparoscopically under general anesthesia. Because no surgical alteration of the stomach or the esophagus is needed, most patients are able to go home the day after surgery and resume a normal diet immediately.
The LINX System offers many benefits for patients with GERD, including:
- Reduction or eradication of heartburn and acid reflux
- Reduction or elimination of anti-reflux medications
- Less invasive than standard surgical treatment for GERD
- Patient discharge within a day after surgery
- Faster recovery and return to normal diet
Is the LINX Reflux Device Right for Me?
If you have experienced symptoms of GERD despite multiple previous efforts to control it, you may be a candidate for the LINX System. Allergies to titanium, nickel, stainless steel, or anything made from iron, may prevent you from having this surgery.
If you have been diagnosed with GERD, but previous treatments haven’t worked for you, contact us to discuss whether the LINX System is right for you.