Gastroesophageal reflux disease (GERD) is a digestive disorder caused by the return of acidic stomach juices, or food and fluids, back up into the esophagus. This "reflux" can irritate the esophagus, causing heartburn and other painful discomfort in the chest and throat. Longstanding GERD has been linked to Barrett's esophagus, a precancerous condition. So treating GERD early and appropriately is very important.
At the Center for Advanced Digestive Care (CADC) of NewYork-Presbyterian/Weill Cornell Medical Center, our gastrointestinal specialists offer care for patients with GERD that is based on the latest medical and surgical advances.
Causes of GERD
- Hiatal hernia (a condition in which part of the stomach moves above the diaphragm, the muscle that separates the chest and abdominal cavities)
- Scleroderma (an auto-immune disease)
- Alcohol (possibly)
- Certain foods can exacerbate the symptoms of GERD (such as chocolate, fatty foods, coffee, and caffeinated beverages)
Diagnosis of GERD
- Upper GI (gastrointestinal) series (also called barium swallow): this test involves swallowing a liquid that can be seen on x-rays as it goes down the esophagus.
- Esophagogastroduodenoscopy (also called EGD or upper endoscopy): a gastroenterologist uses a fiber optic instrument (scope) to see the inside of the esophagus and take tissue samples of any abnormal tissue.
- Bernstein test: a test done in a gastroenterology laboratory to reproduce the symptoms of GERD, such as heartburn.
- Esophageal Manometry: a way to test whether the muscles in the esophagus are functioning properly.
- pH Monitoring: a test to measure acid exposure in the esophagus.
Treatment for GERD
- With one method, radiofrequency energy is used to heat and coagulate tissue around the LES. This creates scar tissue, which alters the sensory nerves that cause the LES to open and close.
- Another minimally invasive method of treating GERD, the "plication" procedure, is performed endoscopically while the patient is under conscious sedation. During this procedure, a device is installed at the junction between the esophagus and stomach. The device grabs and holds tissue and helps tighten the valve between the esophagus and stomach, preventing reflux. Patients usually return home the same day.