Gastroesophageal Reflux Disease (GERD)
GERD or Gastroesophageal Reflux Disease has increased in prevalence along with the rise of obesity in the United States. It is estimated that upwards of 20 million Americans suffer from GERD and tens of millions more suffer from acid reflux regularly. The trend is also causing an uptick in esophageal cancer. Unlike occasional acid reflux, which most suffer from now and then, GERD involves significant acid reflux symptoms several times per week for several weeks at a time. GERD is caused by a number of possible conditions including:
- Excess weight, and resultant abdominal pressure. This the leading cause of GERD and can worsen existing symptoms of GERD.
- Lifestyle patterns that are common risk factors for GERD include consuming spicy, fatty or caffeinated foods and drinks, overeating, and eating soon before bed.
- Some medications such as certain antibiotics, osteoporosis drugs and iron supplements.
- Some medical procedures may cause GERD. For example, the gastric band and gastric sleeve may cause or worsen GERD in a small number of patients.
- Learn more about a gastric band to gastric sleeve conversion due to severe acid reflux.
These and other factors contribute to the continued weakness of the lower esophageal sphincter or LES, the muscle at the bottom of the esophagus that alternately relaxes and contracts to let food and drink through, stopping acid from refluxing.
The Consequences of Untreated GERD
Poor management of GERD symptoms can create a very uncomfortable situation. As acid from the stomach washes upwards, the sensitive lining of the esophagus becomes irritated, sometime even burned. This causes symptoms that can range from mild to downright painful. Some patients mistake their acid reflux symptoms for a heart attack and end up in the emergency room.
Neglecting to address persistent acid reflux can also lead to longer-term damage to the esophagus. Barrett’s Esophagus, a condition in which the cellular lining of the esophagus begins to change due to the constant acidic barrage, can lead to esophageal cancer in some patients.
Treatment for GERD
The first step in the treatment of GERD is lifestyle change. Making small modifications to diet, exercise and eating patterns can go a long way in reducing the severity of symptoms. If the patient does not follow through with their lifestyle change, they may be prescribed one of two drugs – antacids, which neutralize acid in the stomach, or protein pump inhibitors (PPIs), which stop the production of acid. While medication is typically very effective, it only works while it is being taken, and some patients have significant side effects.
The longer-term curative solution for GERD, when lifestyle change and diet has failed to take hold, includes surgery. Currently, we offer two surgical procedures that are both very effective in treating GERD.
Fundoplication for GERD
The Nissen fundoplication is the process of wrapping the upper portion of the stomach around the lower esophageal sphincter, augmenting (tightening) it. A hiatal hernia, very common in obese patients, if found, will be repaired during the procedure. The Nissen is the more common surgery performed for GERD and the standard of care for reflux at this time. Learn more about Nissen Fundoplication.
LINX GERD Treatment
LINX is a newer surgery based on innovative technology in the form of a magnetic and titanium bracelet that is placed around the lower esophageal sphincter to augment the weakened LES. Dr. Tsuda and Dr. Ryan were the first surgeons in Nevada trained to perform this surgery. Learn more about LINX GERD Treatment