Yes, chronic heartburn, also known as acid reflux, can be a sign of gastroesophageal reflux disease (GERD). Persistent exposure to stomach acids can inflame and damage the lining of the esophagus.
It also can lead to a condition called Barrett’s esophagus, characterized by pre-cancerous lesions in the esophageal lining.
At UC Irvine Health, we perform an outpatient procedure to remove Barrett’s esophagus tissue and early esophageal cancer using the Cellvizio® endoscopic system.
With the endoscope, equipped with a tiny microscope, physicians can identify Barrett's lesions at the cellular level, without waiting for lab tests of sample biopsies. Physicians are able to remove the Barrett's disease and even early esophageal cancer cells in one nonsurgical procedure, performed on an outpatient basis.
Depending on the diagnosis, the two are relatively equivalent. Medications, however, can have long-term side effects, including osteoporosis. This is a particularly issue for proton pump inhibitors.
Patients who suffer from GERD have various endoscopic and minimally invasive options to correct a weakened lower esophageal sphincter, the valve that prevents stomach acids from washing back into the esophagus. These procedures are:
- Stretta® — an incision-less outpatient procedure that takes about an hour to perform and provides considerable benefits to patients
- TIF® with EsophyX® — an incision-less procedure to implant a device between the esophagus and the stomach
- LINX® Reflux Management System — a flexible bracelet of magnetic titanium beads inserted through a small abdominal incision and placed around the sphincter to restore it to normal strength
Laparoscopic Nissen fundoplication is the standard surgical treatment for GERD, as well as for paraesophageal and hiatal hernias.
Through a few small incisions, the surgeon uses tiny surgical instruments to wrap the upper part of the stomach, called the fundus, around the lower end of the esophagus. If necessary, the surgeon also repairs any tear in the hiatus, the opening in the diaphragm through which the esophagus connects to the stomach.
Most patients spend one night in the hospital. They are sore for a few days afterward but usually are able to resume routine activities within a week of surgery.
If the patient also is treated for a hiatal hernia at the time of anti-reflux surgery, patients may not engage in vigorous activities or lift anything heavier than 10 pounds for six weeks following surgery.
For the first 10 days, patients are on a full liquid diet. After that, patients slowly move to a regular diet over the course of two weeks.
Once healed from the surgery, patients are typically able to eat whatever foods they wish, including many of those that worsened their heartburn before surgery.