Gastroesophageal Reflux Disease (GERD)
What is heartburn?
Heartburn is a general term that means that your stomach contents (acid and food) may be coming back up your esophagus (the food tube connecting your mouth and stomach). The scientific name is GERD, which stands for gastroesophageal reflux disease. Symptoms of GERD include burning in the pit of the stomach (or chest), feeling that your food is in your mouth and difficulty swallowing. Another common symptom is waking at night with food in your mouth or on your pillow. Other less common symptoms include hoarseness and cough. This could be due to getting your food contents into your voice box and lungs.
Why treat your heartburn?
Untreated heartburn may affect your sleep and your energy level. It often lowers your quality of life. The nagging burning sensation can be very uncomfortable. The usual treatment of heartburn includes antacids like omeprazole. If you drink lots of carbonated drinks like sodas, these should be avoided because they can cause more GERD. Additional treatments include elevating the head of the bed to prevent nighttime heartburn, avoidance of meals before bedtime and losing weight. In spite of all these treatments, some people continue to have severe heartburn.
When your heartburn is treated, you will often sleep better, feel better and have more energy. In addition, you will generally avoid the "burning" sensation in your chest and abdomen.
Complications of heartburn
Serious complications can arise from heartburn and even the treatments. Heartburn may cause lung problems and aggravate asthma and COPD. It may result in irritation to your voice box and affect your voice. It can cause fatigue from affecting your sleep. In addition, heartburn is a known risk factor for the development of esophageal cancer. If you use tobacco products and have heartburn, your risk of esophageal cancer is greatly increased. Some patients develop a precancerous condition of the esophagus called Barrett's disease or Barrett's esophagus. Barrett's results from long-standing heartburn. You may not have any symptoms and still have Barrett's.
The long-term use of antacids can sometimes weaken your bones. These medications may cause you to lose bone mass. When the stomach acid is suppressed, it can limit your ability to absorb calcium. If your body is not absorbing enough calcium, it can weaken your bones over time. The more years you have taken antacids, the greater your chances of breaking bones. We recommend eating/drinking two servings of dairy products per day and taking a vitamin D replacement, depending on your specific needs. Vitamin D often helps your body absorb calcium and build bone mass.
What can we do differently?
Education is key. We encourage you to research the available treatments and ask questions. Services offered at Woodland Heights Medical Center to aid in your treatment include:
- Endoscopic services (placing a scope down the mouth to examine the stomach and esophagus)
- pH monitoring (checking your acid levels in the esophagus)
- Barrett's ablation
- Surgeries to include hiatal hernia repair and TIF procedure
- Radiology services
- Dietitian consultation
The best results often happen when you also make lifestyle changes, such as eating better, eliminating carbonated beverages and possibly losing weight. All these changes can help improve your reflux above and beyond any other treatments.
Surgical treatments for GERD
Many patients with severe heartburn also have a hiatal hernia. A hiatal hernia is a condition in which part of the stomach bulges into the chest cavity via an opening where the esophagus passes on its way to the stomach. Most patients have hiatal hernias with a small portion of the stomach in the chest, and even this will create heartburn. Surgery is first focused on getting the hiatal hernia fixed, which means getting the stomach back down into the abdomen and closing the hole in the diaphragm. These procedures are performed laparoscopically in about an hour.
We also perform the TIF procedure. TIF stands for transoral incisionless fundoplication. During a TIF procedure, a flexible scope is placed through the mouth into your stomach to fold the stomach on itself, which helps to tighten the valve at the lower end of the esophagus. One of the benefits of this procedure is that is does not require any incisions. There are now dozens of medical studies suggesting that the TIF procedure is a valuable tool in combating heartburn.