GERD Requires More Than Over-the-Counter Care

Heartburn. Chest pain. Difficulty swallowing. Chronic Cough. Hoarseness.

On the surface, these seem like common, minor irritations. But these symptoms might point to Gastroesophageal Reflux Disease (GERD), a disorder of the lower esophageal sphincter, or valve, found at the end of the esophagus.

The valve is supposed to keep the digestive system moving like a one-way street, but if that valve grows weak or fails, stomach acid and bile can come up into the esophagus. Over time, this exposure to stomach acid can lead to severe, lasting damage (loss of motility and strictures) and even cancer.

“GERD is the number one cause of esophageal cancer, which we’ve seen an epidemic increase – nearly 600 percent increase – of in the United States, so it is a significant disorder,” said John C. Lipham, M.D., program director for the Hoag Foregut Cancer Program, the James & Pamela Muzzy Endowed Chair in GI Cancer, and associate professor of surgery at Keck School of Medicine of USC. “The problem is patients use a lot of over-the-counter medications that mask the symptoms that don’t actually stop reflux. The only way to truly treat GERD is to treat the underlying problem.”

Lifestyle modifications can help manage the symptoms related to GERD, however, many individuals living with GERD experience a poor quality of life, including being unable to eat or drink certain types of food – such as fatty, spicy, and greasy foods, alcohol and caffeine – or having to sleep sitting up.

For these cases, Hoag is a leader in innovative, minimally invasive techniques to treat complications related to GERD and its associated complications. These include:

Surgical Procedures (to treat GERD):

  • LINX: A bracelet of magnets encased in titanium beads is placed around the weakened valve. This helps the valve stay closed thus preventing reflux from stomach into the esophagus. Hoag was one of the first hospitals in the state to offer this minimally invasive, outpatient procedure, and has developed expertise and currently provides state-of-the-art care.
  • Fundoplication: The top of the stomach is surgically wrapped around the valve and sutured to itself, thus reinforcing the weakened valve. This makes it less likely for acid, bile, etc. to reflux back up into the esophagus.

Endoscopic Procedures (to diagnose and treat the complications of reflux):

  • Esophagogastroduodenoscopy (EGD) with Dilation: Under visual guidance from the endoscope, a balloon is inserted into the esophagus and placed across a narrowed area or stricture. The balloon is then gently inflated to stretch and expand the stricture.
  • Radiofrequency Ablation (RFA): An endoscopic procedure that delivers precise pulses of radiofrequency energy to destroy precancerous cells (Barrett’s Esophagus) that have developed as a result of prolonged exposure to reflux containing acid and bile.