Gastroesophageal Reflux Disease (GERD)
Gastroesophageal reflux disease (GERD) — one of the leading digestive disorders in the United States — sends more than 18 million people in search of medical assistance each year.
Do you suffer from chronic heartburn and painful regurgitation of stomach acids? Our UC Irvine Health esophageal disease specialists at the UCI Health Comprehensive Heartburn Center can provide the most complete evaluation, proactive care and innovative treatments to dramatically lessen your symptoms — or eliminate GERD altogether.
UC Irvine Medical Center is the only healthcare provider in Orange County and Southern California to offer three procedures that are minimally invasive alternatives to standard surgical treatment for GERD. These FDA-approved procedures strengthen the muscle that prevents stomach contents from refluxing, or washing back, into the esophagus. They are:
We also offer the minimally invasive Nissen fundoplication procedure to reinforce the lower esophageal sphincter and prevent reflux. Fundoplication is performed using laparoscopy, which requires only a few small incisions to accommodate tiny surgical instruments, a small video camera and light source.
Get relief for your acid reflux. To schedule a consultation, call 888-717-4463 or complete an online appointment request form ›
People of all ages can develop GERD, many for reasons that are unclear. However, some contributing factors include:
- Asthma medications, antihistamines, pain relievers, sedatives, antidepressants and calcium channel blockers
- Smoking or inhaling secondhand smoke
- Congenital abnormalities
A hiatal hernia can also cause acid reflux. This type of hernia occurs when the upper part of the stomach pushes through the diaphragm, a sheet of muscle that separates the abdomen from the chest. Learn about UCI Health hernia services ›
Learn more about GERD ›
Prolonged exposure to stomach fluids — bile, pancreatic enzymes and stomach juices — can damage the esophagus, the throat and even the vocal cords, resulting in hoarseness or more serious problems.
The corrosive effect of stomach acids may also cause abnormal cells to form in the esophageal lining, a condition called Barrett’s esophagus, which is a precursor to esophageal cancer.
Ulceration and scarring of the esophageal wall may develop into a blockage, or stricture. These, in turn, can lead to a narrowing of the esophagus, which make it difficult for food or medications to pass.
Our esophageal disease specialists are skilled at treating GERD, Barrett’s esophagus and hiatal hernias as well as esophageal cancer. By intervening early, our experts can halt — and even reverse — the disease cycle.
For more information or to schedule a consultation, please call us at 888-717-4463.
If you have frequent bouts of heartburn and regurgitation, your doctor may recommend over-the-counter or prescription medications to reduce the acid produced in your stomach.
Tests and other procedures may be suggested for a more definitive diagnosis and to determine the extent of the problem. They include:
- X-ray of the upper digestive tract — Also called a barium swallow, this test involves drinking a chalky liquid to coat the lining of the esophagus, stomach and upper intestine (duodenum). A series of X-rays can reveal in silhouette the shape and general condition of these organs.
- Upper endoscopy — A thin, flexible tube equipped with a light and a camera is inserted down the throat to inspect the esophagus and stomach for signs of inflammation or complications of acid reflux, such as Barrett's esophagus. During the procedure, the doctor may collect tissue samples for testing.
- Acidity monitoring
— An ambulatory acid (pH) test uses a monitor device to measure when, how much and for how long stomach acids regurgitate into the esophagus, usually for a 48-hour period. The monitor can be a thin, flexible catheter inserted through the nose into the esophagus or a microchip inserted during the endoscopy. The microchip sends data wirelessly to a pager-sized receiver. Correlating the patient's symptoms, food intake and posture with the amount of acid splashing into the esophagus can help with diagnosis.
- Esophageal manometry — A thin, flexible catheter equipped with pressure sensors is threaded through the nose and into the esophagus to measure the strength and coordination of muscle movement. You will be asked to swallow some water to help determine how well your lower esophageal sphincter and other muscles are working.
Depending on the results of these tests, your physician may recommend lifestyle and dietary changes, medications, endoscopic procedures or surgery.
Once GERD is accurately diagnosed, dietary and lifestyle changes are usually prescribed to prevent pain and heartburn from affecting normal activities. These include:
- Losing weight, if necessary — Extra pounds put pressure on the abdominal area.
- Eating smaller meals, more slowly — This allows food to move more quickly through the digestive system.
- Avoiding food and drinks that worsen symptoms — Heartburn can be triggered by fried or fatty foods, alcohol, chocolate, peppermint, garlic, onions or caffeine.
- Staying upright after eating — Wait at least three hours after a meal to nap or go to bed.
- Quitting smoking — Smoking has been shown to loosen the esophageal sphincter.
- Raising the head of your bed — Elevate the head of your bed six to eight inches with blocks or a wedge. Pillows alone are insufficient.
Over-the-counter or prescription medications may also be recommended, such as:
- Antacids to help neutralize stomach acids
- H2 blockers (such as Pepcid AC, Tagamet or Zantac) to reduce the production of stomach acids
- Proton pump inhibitors (such as Prilosec, Nexium or Prevacid), which also reduce stomach acid production, but over a longer period of time
- Prokinetics (such as Reglan) to help temporarily tighten the sphincter and increase movement in the esophagus and stomach, but they may also produce fatigue, anxiety, sleepiness, memory and movement problems
Medications may control symptoms in many GERD patients. However, recent studies indicate that their long-term use, especially proton pump inhibitors, have been associated with serious side effects, including osteoporosis-related hip fractures.
When medications no longer adequately control acid reflux, the standard treatment has been fundoplication surgery, usually through a few small abdominal incisions. This minimally invasive surgery also is used to correct a hiatal hernia, which can cause GERD symptoms.
Fundoplication, also known as "the wrap," involves wrapping the upper part of the stomach around the lower esophageal sphincter to bolster it. A patient is typically hospitalized for a day, followed by light-duty recuperation for a few weeks.
Our esophageal disease specialists can combat GERD with an array of less invasive, FDA-approved alternatives to match your needs and diagnosis. Learn more about:
Our team of GERD specialists at the UCI Health Comprehensive Heartburn Center includes board-certified and fellowship-trained gastroenterologists, interventional gastroenterologists and gastrointestinal surgeons. They work together to provide the most accurate diagnosis and develop a therapy regimen tailored to your individual needs.
Our team also includes highly skilled nurses, dietary specialists and other healthcare professionals experienced in the care of patients with gastrointestinal disorders.
Our physicians include:
- C. Gregory Albers, MD
- William E. Karnes, MD
- Robert H. Lee, MD
- Hooshang Meshkinpour, MD
- Michael D. Molinari, MD
- Douglas Nguyen, MD
- Nimisha Parekh, MD, MPH
- Sandra Sunhee Park, MD
- Edward J. Politoske, MD
- Carlos Saad, MD
- Khoi Tran, MD