Gastroesophageal Reflux Disease (GERD)

Gastroesophageal reflux disease (GERD) is a medical condition where stomach acid travels upward from the stomach and into the esophagus. This acid reflux can cause uncomfortable symptoms after eating, such as heartburn. More than 3 million Americans are diagnosed with gastroesophageal reflux disease every year. Countless more suffer the symptoms of GERD without seeking medical care because they lack adequate information about this treatable condition.

At The University of Kansas Health System in Kansas City, our experienced surgeons offer minimally invasive surgical procedures that resolve GERD symptoms for the long-term.

The esophagus is the tube that connects your mouth to your stomach. At the end of the esophagus is the lower esophageal sphincter, a muscle that’s responsible for keeping swallowed food and liquids in the stomach once they’ve entered. In someone with GERD, this muscle relaxes and opens, which allows stomach acid to flow back upwards into the esophagus.

Anyone can experience heartburn or acid reflux from time to time. However, GERD is diagnosed when acid reflux symptoms occur with regular frequency. This consistent backwash of stomach acid irritates the esophageal lining. Over time, the esophagus can narrow and cause swallowing difficulties. Without appropriate treatment, frequent GERD sufferers can even develop ulcers or precancerous lesions in their esophagus.

GERD is broken down into different stages based on how serious your symptoms are and how often they occur:

There are several symptoms that could indicate the presence of GERD:

• Aspiration, when food rises through the esophagus and returns down the trachea
• Chronic hoarseness or cough
• Dental problems
• Difficulty swallowing (resulting from scarring)
• Frequent heartburn
• Regurgitation of food, especially at night

Anyone can get gastroesophageal reflux disease, but the risks are increased in people who:

• Are obese
• Have a hiatal hernia
• Live with a connective tissue disorder

Women who are pregnant can also experience GERD during their pregnancy.

Lifestyle choices are another risk factor in developing GERD:

• Eating large meals late at night
• Excessive drinking of alcohol or coffee
• Smoking

Many people with GERD find that certain foods trigger their GERD symptoms, such as fried, fatty or spicy foods. If acid reflux is mild and flares up only in response to specific foods, simple dietary changes may be enough to control your GERD symptoms.

Our experienced specialists use several diagnostic techniques:

• 24-hour pH study via Bravo capsule, in which your doctor will place a small capsule containing a tiny transmitter at the base of your esophagus, where it will collect data as you go about your normal activities. The capsule will eventually dislodge and pass as a waste product.
• Endoscopy, in which a narrow scope equipped with a light and camera is used to view the upper digestive tract.
• Esophageal manometry, which measures the function of the lower esophageal sphincter, the valve that prevents acid reflux. A small catheter is inserted via the nose and guided down into the stomach. Sensors on the catheter measure the activity of the esophagus over about a 15-minute period. You will not be sedated, but will be given pain medication to reduce discomfort. While possibly uncomfortable, the test is not painful and reveals important data doctors will use to make care decisions for you.

GERD can afflict children and adults of all ages. People with GERD may face decades of medication use, which can carry its own set of risks and inconveniences. Many of those who take daily medication to control their GERD symptoms may be unaware that a long-lasting correction of the problem is within reach. Surgical correction may offer a better long-term outlook than symptom control alone.

GERD surgery can be performed as an open or laparoscopic surgery to tighten and strengthen the lower esophageal sphincter. When done laparoscopically, incisions are small and recovery time reduced.