GERD

Gastroesophageal reflux disease (GERD) occurs when the muscle at the end of the esophagus (the “food tube” that connects the mouth to the stomach) does not close properly. With the muscle left open, stomach acid pushes up into the esophagus and irritates its lining. Most people are familiar with this burning sensation from having occasional heartburn. If it happens twice or more in a week, doctors consider it GERD. GERD also can feel like asthma, a dry cough, or difficulty swallowing. It can affect people of any age. Untreated cases can disrupt daily life and lead to more serious conditions.

Treating GERD

Treatment options for GERD include medications or surgery. Three popular medications are designed to decrease stomach acid. Calcium carbonate neutralizes stomach acid immediately, but only in the short term. H2 blockers (H2Bs) and proton pump inhibitors (PPIs) decrease stomach acid production over a longer period. These medications can be purchased over the counter or prescribed by your doctor.

Doctors may use surgical procedures to treat GERD as well (the two most common are discussed below). First, the following three tests are required to determine if you are a candidate for anti-reflux surgery:

Esophageal pH testing, which tests for acid in the esophagus
Manometry/motility testing, which measures pressure in the esophagus and swallowing
Endoscopy procedure, which allows doctors to see inside the esophagus and stomach using an endoscope (a flexible tube with a tiny camera on the end that is inserted through the mouth into the stomach)

Nissen fundoplication

Doctors consider it the gold standard of anti-reflux procedures. According to research, 85-90% of patients see their symptoms improve after Nissen fundoplication. During this procedure, surgeons wrap the patient’s stomach tightly around itself to block acid from reaching the esophagus. It is a minimally invasive procedure, which means that only small incisions (cuts) are required. Surgery is usually complete in just 2-3 hours. Because it changes a patient’s anatomy, the procedure can cause side effects such as difficulty belching and gas-bloat syndrome.

The LINX device

The LINX is a small, flexible band of magnetic beads, around the size of a quarter. Surgeons implant the LINX by wrapping it around the patient’s weakened lower esophageal sphincter (LES), the body’s natural barrier to reflux. The implanted band is designed to open when a patient swallows food and then close to block stomach acid from coming back up. This minimally invasive procedure takes about an hour, and many patients are able to go home within 24 hours, without further medication.

We also have other surgical options for treating GERD. Your surgeon will help you decide which procedure is right for you. In general, anti-reflux surgery presents low risk, with only 1-4% of patients experiencing complications.

UAB Medicine GI Program

UAB Medicine is known worldwide as a leading center for digestive and liver disorders. Our gastroenterology and gastrointestinal (GI) program is consistently ranked among the top programs of its kind in the nation by U.S. News & World Report. We see more than 20,000 patients and perform more than 12,000 outpatient procedures each year.

Our GI program is also historically significant. The inventor of the endoscope, Basil Hirschowitz, MD, founded our program more than 50 years ago. His innovation revolutionized GI and other diagnoses around the world. Our interventional endoscopy group, which includes endoscopic ultrasound, is one of the busiest and most prestigious in the country — clinically and academically.

UAB continues to lead advancements in gastroenterology by participating in many research trials of promising drug therapies and other treatments for digestive disorders. Our doctors and scientists are searching for causes and cures for many GI illnesses through basic research. For example, they study how the bacteria in our intestines affect our health.