Reflux and Heartburn Center

GERD happens because of a problem with the ring of muscle at the end of the esophagus called the lower esophageal sphincter (LES). It acts like a one-way valve between the esophagus and the stomach. When you swallow, the valve lets food pass into the stomach. With GERD, the valve doesn't close tightly enough. Stomach acid and juices flow back up (reflux) into the esophagus.

Frequent acid reflux can lead to irritation of the esophagus (esophagitis), narrowing of the esophagus (stricture), or development of sores (ulcers) in the esophagus. Long-term exposure of the esophagus to stomach acid causes the cells that line the inside of the esophagus to be replaced by cells like those that line the inside of the stomach (Barrett's esophagus). This change in cells has been associated with an increased risk of esophageal cancer.

GERD usually happens when the valve relaxes at the wrong time and stays open too long. Some things may relax the valve so it doesn't close tightly or some foods and drinks can make GERD worse. These may include chocolate, mint, alcohol, pepper, spicy foods, high-fat foods, or drinks with caffeine in them, such as tea, coffee, colas, or energy drinks. If your symptoms are worse after you eat a certain food, you may want to stop eating it to see if your symptoms get better.

Other things can make stomach juices back up, such as:

• Hormonal changes during pregnancy.
• A weak lower esophageal sphincter.
• A hiatal hernia.
• Slow digestion.
• An overfull stomach.

Surgery may be used to treat GERD symptoms that haven't been controlled well by medicines. The following are the ways in which GERD is managed surgically.

• Fundoplication
• Gastric Bypass
• LINX

Fundoplication:

The most common surgery used to treat GERD is fundoplication. It strengthens the valve (lower esophageal sphincter) between the esophagus and stomach. This helps keep acid from backing up into the esophagus as easily. It relieves GERD symptoms and inflammation of the esophagus.

It may be done in one of two ways.

• A partial fundoplication. With this, the stomach is wrapped only partway around the esophagus.
• A full fundoplication. With this, the stomach is wrapped all the way around the esophagus.
• These procedures are performed laparoscopically or robotically, meaning that a lighted scope and special tools are used through small cuts in your belly to perform the procedure.

For patients who struggle with obesity and GERD, the gastric bypass may be the solution. The gastric bypass is a bariatric procedure that will treat both obesity and GERD, as well as treat or help prevent other diseases like high blood pressure, high cholesterol, obstructive sleep apnea and more.  If you are interested in this surgery, please visit our site to sign up for a seminar.

The Linx device is a small ring of magnetic beads. It helps keep acid in your stomach by strengthening the valve between the esophagus and stomach. This does require a laparoscopic surgery and the use of special tools to insert the device around the LES.