Gastrointestinal disorders disrupt the lives of millions of Americans every year. In fact, a report by the Centers of Disease Control and Prevention (CDC) found that digestive diseases were diagnosed at 32.3 million doctor visits in the U.S. in 2015*. Dr. Leggett & Dr. Lee provide specialized treatment for patients experiencing chronic esophageal and stomach reflux diseases using both non-invasive and minimally invasive surgical therapies.
Gastroesophageal reflux disease (GERD)
GERD or gastroesophageal reflux disease is the result of a weak muscle within the esophagus, called the lower esophageal sphincter, which acts as a reflux barrier within the body. When functioning correctly, the barrier acts as a one-way valve that allows food to flow into the stomach and prevents stomach contents from flowing back up into the esophagus However, people who experience GERD have a barrier that does not function properly
allowing acid and bile to flow back into the esophagus
symptoms of Laryngopharyngeal Reflux:
- Chronic cough
- Adult-onset asthma/bronchitis
Etiology:
- Hiatal Hernia can also cause GERD and may need surgical correction
When left untreated, acid reflux or GERD can be very painful and can damage the lining of the esophagus and potentially lead to more concerns. If you are experiencing GERD symptoms, an appropriate diagnosis is critical to understanding your reflux condition and developing the right treatment plan for you.
For some people, GERD poses a serious medical problem. Severe cases of GERD can lead to esophagitis, Barrett’s esophagus, strictures, and esophageal cancer.
GERD risk factors
- 40 years old and above
- Being overweight
- Diabetes
- Diet
- Performing Jobs that require stooping, bending, or heavy lifting
- Pregnancy
- Smoking
- specific lifestyle choices, including a diet of alcohol, citrus, caffeinated beverages, tomato-based foods, chocolate, spicy foods, and peppermint
Minimally invasive and non-invasive treatment options
If non-surgical GERD treatment, like lifestyle modification and medication management, have not been effective our heartburn and reflux care team offers several treatment options to best fit your healthcare needs We offer the following minimally invasive and non-invasive treatments to treat GERD
Heller myotomy
This is a minimally invasive surgical procedure used to treat achalasia. A surgeon cuts the muscles of the lower esophageal sphincter allowing food and liquids to pass to the stomach.
Hiatal hernia repair
This procedure recreates or reinforces the muscles surrounding the lower esophagus/paraesophageal hernia repair.
Gastrectomy or esophagectomy
These most modern resection techniques are used above the stomach.
Nissen or toupet fundoplication
This is a laparoscopic procedure in the abdomen that allows the physician to directly see and operate on the stomach. This surgery uses small incisions to pass surgical tools into the abdomen to complete the surgery. Your surgeon will view the areas on a screen wIth Images from a small camera inserted into the abdomen.
Partial gastrectomy with Roux-en- Y reconstruction
This procedure is used for weight loss surgery and can be used for the treatment of gastric reflux on patients with previous sleeve gastrectomy surgery or in patients with persistent obesity
Radio frequency ablation for Barrett’s esophagus
This procedure can minimize the risk of developing esophageal cancer if a patient has Barrett’s esophagus due to GERD. The procedure involves the patient swallowing a thin, flexible lighted tube called an endoscope. The endoscope transmits images of the inside of the esophagus allowing the physician to see which areas require treatment. A catheter is also Inserted into the esophagus to deliver energy to the abnormal tissue. The procedure can minimize or prevent abnormal cells from developing into a cancerous condition
Endoscopic radiofrequency (RF) energy for reflux treatment
This therapy delivers radio frequency energy to the muscle between the stomach and esophagus, which improves the muscle tissue. The result is an enhanced barrier function and fewer reflux events. This surgical option treats the underlying problems that may cause GERD without surgery.
Diagnostic testing for GERD
Your physician may suspect GED based on your symptoms and medical history. We offer a range of tests to diagnose your condition.
Catheter-free esophageal pH monitoring
This testing option measures acid from the stomach reaching the esophagus to diagnose GERD. The test is performed by using a capsule that is temporarily attached to the wall of your esophagus to monitor your pH over a period of 48 to 96 hours
Esophagogastroduodenoscopy (EGD)
This testing option helps physicians visualize the esophagus, stomach and duodenum to identify hiatal hernias, evidence of reflux or possible swallowing concerns
Esophageal high-resolution manometry
A special tube is passed through your nose and into the esophagus. The tube measures the pressure that the muscles in the esophagus creates and evaluates the function of the esophagus and may be used to diagnose swallowing problems
Cellvizio
Real time endomicroscopy to evaluate for Barrett’s esophagus during EGD.
Based upon the results of your tests there are several digestive diseases, which may be causing your symptoms:
- Achalasia
- Barrett’s esophagus
- Esophageal gastric cancer
- Gastroesophageal reflux disease (GERD)
- Gastroparesis
- Hiatal hernia
Endo Flip
Measures esphageal pressures during EGD to hold difuse GERD.
24-hour esophageal pH impedance reflux monitoring
This testing option measures the amount of reflux, both acidic and non-acidic, ni your esophagus throughout a 24-hour period by placing a small catheter that assesses whether your symptoms are correlated with reflux.
Nuclear gastric emptying imaging
This diagnostic testing scan follows how quickly food moves through and leaves your stomach. This procedure is used to diagnose gastroparesis.
Upper GI Flouroscopy and Videoesphagogram (VEG)
A radiological study that provides a visual assessment of the esophagus, stomach and the first part of the small intestine, called the duodenum, to determine the size of the hiatal hernia and the emptying of your esophagus.
Dr. Leggett & Dr. Lee offers comprehensive heartburn and reflux treatment options that can help you determine the right combination of lifestyle changes and medication options. We offer minimally invasive anti-reflux surgery options to both study and treat the most complex cases of GERD successfully, including revisional surgery from previously failed procedures. They provide specialized treatment for patients experiencing chronic esophageal and stomach reflux diseases.
We will guide you through the process of evaluating and testing for reflux disease as well as provide support and answer any questions you may have while receiving treatment.
Reterences:
*Centers for Disease Control and Prevention (CDC). National Ambulatory Medical Care Survey
2016 National Summary Tables; https://www.cdc.gov/nchs/tastats/digestive-diseases.htm