Gastroesophageal Reflux Disorder (GERD)

You've probably felt it before. It's a pain in the chest and throat that results from gastroesophageal reflux disease (GERD), commonly known as heartburn.

A recent Gallup Survey reports that 40 percent of all Americans suffer from some sort of heartburn at least once a month. These individuals suffer from chronic heartburn or what is known as gastroesophageal reflux disease (GERD). While over-the-counter antacids and prescription medications may provide adequate relief of symptoms for occasional to moderate heartburn sufferers there are over 1 million people in this country for whom no amount of medication will provide relief.

What is GERD?

GERD occurs when the muscles surrounding the valve between the esophagus and the stomach becomes weak and allows acid from the stomach to leak upward into the esophagus.

When weakened, this valve can allow stomach acid and food to surge upwards into the esophagus, causing painful heartburn and indigestion. Symptoms of the condition may include a burning sensation in the chest or abdomen, indigestion, regurgitation, difficulty sleeping after eating, hoarseness or sore throat.

For many people, symptoms can occur several times a day, particularly at night when a person lies down to go to sleep, and continue from week to week and year to year. Diet and lifestyle may also make a person more susceptible to GERD. Consumption of fried, fatty or spicy foods, caffeinated beverages, alcohol and chocolate, as well as obesity, pregnancy, smoking and the natural aging process can worsen the symptoms of GERD.

If left untreated, reflux may lead to respiratory problems, ulceration of the esophagus or even esophageal cancer.

Treatment Options

The good news is that chronic GERD symptoms can be alleviated with a number of minimally invasive procedures, including:

Endocinch
The EndoCinch System™, like a tiny sewing machine, is attached to the end of a standard, flexible endoscope or tube. It allows the physician to place a suture (stitch) in the soft tissue of the esophagus and stomach (called the lower esophageal sphincter or LES). Two stitches can be placed and tied together to create a pleat. The pleat prevents acid from flowing out of the stomach and into the esophagus.

EndoCinch does not require an incision and is performed on an outpatient basis. Most patients usually will be home in the early afternoon. Typically, only mild sedation is required (no general anesthesia), so you can return to normal activities the next day.

Videoscopic Surgery
Many chronic heartburn sufferers are finding out that a videoscopic surgical procedure may be an effective treatment option. While the videoscopic approach is new, the procedure itself has been performed since the 1950s with traditional surgery.

For many patients, daily heartburn prevents restful sleep, makes eating difficult and generally affects all aspects of their lives. This simple procedure may reduce a patient's symptoms providing them with a better quality of life.

Developed a few years ago, this procedure has helped thousands. The surgeon makes five small incisions, each less than one inch, in the abdomen to accommodate small tubes called trocars. These create a passageway for special surgical instruments and a laparoscope. A laparoscope is a fiber optic instrument that is inserted in the abdominal wall and is used to visually examine the interior of what is known as the peritoneal cavity. This device is used to transmit images from within the body to a video monitor, allowing the surgeon to see the operative area on the screen. They then use the surgical instruments to wrap a portion of the stomach around the lower esophageal sphincter to prevent the flow of acid into the esophagus.

The minimally-invasive procedure is less traumatic than traditional surgery. In most cases, videoscopic surgery reduces scarring and shortens hospital stays and recovery time. Patients are usually released from the hospital in one to two days as compared with the nine days required for traditional surgery. In many cases recovery time can be as little as seven to 13 days, compared with 28 days for traditional surgery.

The surgical team at The George Washington University Hospital performs hundreds of laparoscopic procedures each year. Individuals who think they may have chronic heartburn should see their physician or gastroenterologist to determine the cause and severity of the problem, the proper steps to take to improve their condition, and to determine if he or she is an appropriate candidate for videoscopic surgery.

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