Chronic Heartburn And Swallowing Disorders

Most of us experience heartburn from time to time.

But if you take over-the-counter heartburn medication twice a week or more, you should see your doctor.

Many people think heartburn is annoying but harmless. However, frequent heartburn or acid reflux indicates a real medical condition known as gastroesophageal reflux disease (GERD). Left untreated, GERD can lead to ulcers and throat cancer.

GERD

Gastroesophageal reflux (GERD) is a chronic digestive disorder caused by stomach acid flowing back from the stomach into the esophagus.

Heartburn, the most common symptom of GERD, is associated as a burning sensation that begins in your chest, and that sometimes moves to your neck and throat. GERD seems to get worse after eating, but the primary cause is weakness in the lower esophageal sphincter (LES) muscle, which opens to allow food into the stomach and the closes to keep it in. When the LES muscle relaxes inappropriately or is weak, stomach acid flows back into the esophagus, triggering heartburn.

Not everyone experiences heartburn with GERD. Other symptoms include dry cough, asthma-like symptoms, and difficulty swallowing. If you suspect you may suffer from GERD, you should consult your primary care physician who may refer you to a gastroenterologist specialist.

Left unattended, chronic inflammation can lead to longer-term complications, including:

  • Narrowing of the esophagus due to scar tissue, making it difficult to swallow
  • Esophageal ulcers, which bleed and cause pain, making it difficult to swallow
  • Changes to the cells lining your esophagus, a pre-cancerous condition that needs to be monitored

LPR

Like GERD, laryngopharyngeal reflux disease (LPR) is caused by acid backing up in your digestive system. LPR affects the more sensitive lining of the upper esophagus, larynx, and pharynx.

LPR is sometimes called “silent reflux” because it doesn’t cause the traditional symptoms like heartburn and indigestion. People with LPR often complain of throat issues like hoarseness, dry cough, or feeling like there’s a lump or mucous in their throat.

Diagnosing LPR is a real challenge. In fact, LPR can easily be mistaken for other conditions like allergies or laryngitis. But now, a highly sensitive test can determine if you have acid backing up into your throat. The latest pharyngeal pH monitoring system provides an easier, more accurate way to determine if acid is reaching your throat.

A pH probe test takes 24 hours. We’ll insert the sensor into the back of your throat and then let you continue normal activities for a day. (It doesn’t interfere with your ability to talk, eat, or drink.) The probe is connected to a recording device, tracking the frequency and severity of reflux episodes.

At the end of a 24-hour period, we’ll remove the probe. Your doctor then evaluates this data and can make a diagnosis. As a result, you get a more accurate, personalized treatment plan – one that better ensures we’re getting at the true cause of your symptoms.

Barrett's Esophagus

Barrett's esophagus is a condition that results when the normal cells lining your esophagus change and the risk of cancer is increased. The process is called intestinal metaplasia because the changed esophageal cells, referred to as columnar cells, are similar to the cells lining your intestine.

If you have a long-standing experience with heartburn, you are at risk for Barrett’s esophagus. Having Barrett's esophagus may increase your risk for developing esophageal cancer.

Everyone experiences symptoms differently, and some individuals with Barrett’s esophagus have no symptoms at all. Common symptoms may include:

  • Blood in vomit or stool
  • Difficulty swallowing
  • Vomiting
  • Waking in the night with heartburn pain

Treating GERD, LPR, and Barrett’s Esophagus

At Aurora BayCare, we diagnose and treat a variety of digestive tract disorders using minimally invasive general endoscopy procedures, including upper gastrointestinal endoscopy (EGD), esophageal manometry, LINX and ambulatory 24-hour esophageal studies.

In most cases, GERD, LPR, and Barrett’s esophagus symptoms can be managed with non-surgical treatment such as medication and lifestyle changes. Alcohol, caffeine, chocolate, mints, and fatty foods relax the lower esophageal muscle, so avoiding these may minimize your symptoms. In rare cases where surgery is recommended, your GI specialist will review your options for surgical intervention.

Barrett’s esophagus should be monitored for tissue damage and cancer. We offer HALO radiofrequency ablation or RFA, which is an option to remove abnormal Barrett's tissue. With RFA, radio waves are delivered via a balloon- or endoscope-mounted catheter to remove damaged tissue while minimizing injury to the surrounding healthy esophagus.

We also offer a minimally-invasive procedure known as a “endoscopic mucosal resection” or EMR. With EMR we can remove abnormal tissue from your digestive tract using a long narrow tube equipped with a light, camera, and tiny surgical instruments.

LINX® for GERD

Aurora BayCare offers LINX, an innovative and minimally invasive surgical option for treating GERD. LINX is a series of flexible magnetic beads surgically placed around the lower esophageal sphincter (LES) to aid its function and prevent reflux. Most patients return home able to resume their normal diet and activity immediately.

LINX offers many benefits to those suffering from GERD:

  • Designed to last a lifetime
  • Lessened bloating and gas
  • 20-30 minute outpatient surgery
  • Small incision with minimal scarring
  • Maintain normal diet and activity after procedure

According to a clinical study, 92% of patients were able to stop daily medication for GERD. Symptom improvement was also seen in 92% of patients.