It might be something more serious. If you suffer from frequent heartburn, you’re not alone. More than 60 million American adults report heartburn symptoms at least once a month. More than 15 million deal with it every day. But what’s the cause? And is there a solution?
“GERD occurs when the communication between the esophagus and the stomach is abnormal, and gastric acid refluxes up in to the esophagus,” says Heath Giles, M.D., board certified general surgeon with University Surgical Associates. “It leads to heartburn and indigestion initially, and then eventually leads to other symptoms like clearing of the voice, coughing, and difficulty swallowing. When left untreated, the condition will continue to progress to constant coughing and hoarseness through the day and night, and damage to the esophagus itself.”
Lifestyle Changes, Medications, Surgery
“For people who have not seen relief with those treatments or are having complications – like changes in the esophagus that could be pre-cancerous, having issues with pulmonary problems like asthma and bronchitis, complications with a hiatal hernia, difficulty swallowing, compression of the stomach – an evaluation for anti-reflux surgery is appropriate,” Dr. Giles says.
“If anti-reflux surgery is necessary, it’s important that each individual receives the right procedure. That decision is based on a range of tests that give the surgeon information about how a person’s body would likely respond,” Dr. Giles explains. “When people come to see us for this surgery, they are understandably interested in moving quickly to schedule the procedure. But in order to ensure we are offering the right option for every person, we need a large body of information to make the most informed and best decision that leads to a good outcome.”
The Process of Diagnosis
- Upper endoscopy is a procedure that looks inside the digestive tract (esophagus, stomach and upper part of the small intestine) and is used to identify inflammation, ulcers, and rule out the potential for other malignancies (or presence of tumors). It also helps confirm whether acid reflux has resulted in changes within the esophagus that are consistent with the condition.
- An esophageal motility study (EMS) assesses the function of the upper and lower esophageal sphincter to determine if there is an appropriate level of esophageal motility. This is important because during the anti-reflux procedure, the stomach is wrapped around the base of the esophagus to tighten the communication between the two organs. This naturally creates a partial obstruction, and it’s important to understand how that will affect other parts of the digestion process.
- A barium swallow test can be used to determine the cause of painful swallowing, difficulty swallowing, or to rule out any structural problems in the esophagus. During this painless test, x-rays of the esophagus are taken after swallowing a solution of barium.
Armed with Information
“Recovery from anti-reflux surgery generally involves an overnight hospital stay, with the majority of patients going home the next day. Dietary modifications, including a complete liquid diet for two weeks and a progressive advancement of soft foods over the next month, are necessary for proper healing,” Dr. Giles says. “This slower paced recovery is directly related to how the procedure changes a person’s eating patterns. Many people learn to eat more slowly – leading to healthier eating and ultimately weight loss.”