Gastroesophageal reflux disease (GERD), also referred to as acid reflux, is a chronic digestive disease that occurs when stomach acid or bile flows back (refluxes) into the esophagus. Approximately 1 in 5 adults experience symptoms of GERD, including persistent heartburn or regurgitation, at some point in their lives. Over time, chronic exposure of the esophageal lining to stomach acid can cause more serious conditions such as Barrett’s esophagus and esophageal cancer.
At West Coast Thoracic Surgery, we believe that proactive treatment and careful monitoring of GERD symptoms are crucial to enhancing our patients quality of life and preventing progression of esophageal disease. Our renowned thoracic surgeons, Ali Mahtabifard, MD and Clark Fuller, MD, are highly experienced in the treatment of GERD and offer a comprehensive diagnostic and treatment approach tailored to each patient’s specific condition.
Diagnosing Acid Reflux (GERD)
The primary symptoms of GERD, heartburn and regurgitation, are the result of failure in the natural barrier between the esophagus and stomach contents. As the esophagus passes from the chest cavity into the abdomen and stomach, it relies on a valve created by sphincter and diaphragm muscles to prevent acid reflux. When this valve becomes weakened, either by shortening of the esophagus or migration of the stomach into the chest (hiatal hernia), stomach acid can flow backwards and damage the esophageal lining. In some cases, an individual with long-standing GERD may experience difficulty passing food down the esophagus, indicating a narrowing of the esophageal lining (stricture).
If acid reflux or a more serious esophageal condition is suspected, our surgeons will perform an outpatient procedure known as an upper endoscopy (EGD). Upper endoscopy is an extremely useful diagnostic tool that involves feeding a flexible camera through the mouth and esophagus, down into the stomach. During this procedure, our surgeons can examine the competence of the esophageal valve and explore possible anatomical abnormalities, such as a hiatal hernia, Barrett’s esophagus and ulcers. An EGD can be performed in under 20 minutes while under sedation to prevent pain or discomfort, and is the single most important procedure in the diagnosis of GERD.
Other diagnostic tests which may be employed include a 24 hour pH study, 48 hour Bravo study, impedance study, esophageal manometry, and/or barium esophagram. It is vitally important to complete a thorough work up of each patient to ensure the most accurate diagnosis and ultimately the best clinical result. Our surgeons will tailor which tests are required to the exact clinical presentation of each patient.
Treatment for Acid Reflux (GERD)
The symptoms of GERD can be very unsettling and will not resolve without some form of treatment. In fact, untreated acid reflux disease can lead to more serious esophageal conditions including Barrett’s esophagus, a precursor to esophageal cancer.
Acid suppression medications are the first line of treatment for GERD and may alleviate the symptom of heartburn. However, medications do not resolve regurgitation or motility problems associated with a damaged esophageal valve. Patients who do not respond to medication or who wish to avoid potential side effects associated with long-term medication use may be good candidates for reflux surgery.
Reflux surgery involves reconstructing the natural barrier between the esophagus and stomach to prevent acid reflux. Depending on the extent of esophageal damage and individual anatomy, our thoracic surgeons utilize one of the following techniques:
Both the TIF procedure and Nissen Fundoplication can be performed with a one night stay. As leading experts in the field of minimally invasive thoracic surgery, Ali Mahtabifard, MD and Clark Fuller, MD are able to perform reflux surgery with a very high success rate and low risk of complications. Most of our patients report relief from heartburn and regurgitation and are able to stop taking reflux medication entirely following reflux surgery.
Contact an Acid Reflux Specialist
If you experience persistent heartburn or have been diagnosed with gastroesophageal reflux disease, it is important to seek treatment from an experienced thoracic surgeon. While not every patient will require reflux surgery, our surgeons can assess your specific condition and provide the most effective relief from acid reflux.
To learn more about gastroesophageal reflux disease (GERD) or to schedule a consultation with one of our expert thoracic surgeons, please call 310.854.0909 or fill out our online contact form.
Next, read about esophageal cancer.