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Gastroenterology



GERD

Methodist Health Systems - A Word About GERD eBook

Gastroesophageal Reflux Disease (GERD) patient education animation

What is Gastroesophageal reflux disease (GERD)?

Gastroesophageal reflux disease (GERD) is a digestive disorder that is caused by gastric acid flowing from the stomach into the esophagus.

Gastroesophageal refers to the stomach and esophagus, and reflux means to flow back or return. Gastroesophageal reflux (GER) is the return of acidic stomach juices, or food and fluids, back up into the esophagus.

What are the symptoms of GERD?

Frequent heartburn? Difficulty swallowing? Chronic indigestion? Annoying hiccups? You may have GERD (Gastroesophageal Reflux Disease). Learn more about innovative treatments for GERD at the hospitals of Methodist Health System. Listen to our radio ad.
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Heartburn, also called acid indigestion, is the most common symptom of GERD. Heartburn is described as a burning chest pain that begins behind the breastbone and moves upward to the neck and throat. It can last as long as two hours and is often worse after eating. Lying down or bending over can also result in heartburn.

Some adults diagnosed with GERD will experience a dry cough, asthma symptoms, or trouble swallowing, instead of heartburn. Heartburn pain is less likely to be associated with physical activity.

The symptoms of GERD may resemble other medical conditions or problems. Always consult your physician for a diagnosis.

What causes GERD?

GERD is believed to be the result of condition called hiatal hernia, which affects the lower esophageal sphincter (LES). The typical cause of heartburn is when acid from the stomach backs up into the esophagus. The LES, a muscle located at the bottom of the esophagus, opens to let food in and closes to keep it in the stomach. When this muscle relaxes too often or for too long, acid refluxes back into the esophagus, causing heartburn.

Other lifestyle contributors to GERD may include the following:

  • Being overweight
  • Overeating
  • Consuming certain foods, such as citrus,chocolate, fatty, and spicy foods
  • Caffeine
  • Alcohol
  • Smoking
  • Use of nonsteroidal anti-inflammatory (NSAIDs) drugs such as aspirin and ibuprofen

Other medical causes of heartburn may include the following:

  • Gastritis – an inflammation of the stomach lining
  • Ulcer disease

How is GERD diagnosed?

In addition to a complete medical history and physical examination, diagnostic procedures for GERD may include the following:

  • Upper GI (gastrointestinal) series – a diagnostic test that examines the organs of the upper part of the digestive system: the esophagus, stomach, and duodenum (the first section of the small intestine). A fluid called barium (a metallic, chemical, chalky, liquid used to coat the inside of organs so that they will show up on an x-ray) is swallowed. X-rays are then taken to evaluate the digestive organs.
  • EGD or upper endoscopy – a procedure that allows the physician to examine the inside of the esophagus, stomach, and duodenum. A thin, flexible, lighted tube, called an endoscope, is guided into the mouth and throat, then into the esophagus, stomach, and duodenum. The endoscope allows the physician to view the inside of this area of the body, as well as to insert instruments through a scope for the removal of a sample of tissue for biopsy (if necessary).
  • Bernstein test – a test that helps to confirm that the symptoms are a result of acid in the esophagus. The test is performed by dripping a mild acid through a tube placed in the esophagus.
  • Esophageal manometry – test that helps determine the strength of the muscles in the esophagus. It is useful in evaluating gastroesophageal reflux and swallowing abnormalities. A small tube is guided into the nostril, then passed into the throat, and finally into the esophagus. The pressure the esophageal muscles produce at rest is then measured.
  • pH monitoring – measures the acidity inside of the esophagus. It is helpful in evaluating gastroesophageal reflux disease (GERD). A thin, plastic tube is placed into a nostril, guided down the throat, and then into the esophagus. The tube stops just above the lower esophageal sphincter, which is at the connection between the esophagus and the stomach. At the end of the tube inside the esophagus is a sensor that measures pH, or acidity. The other end of the tube outside the body is connected to a monitor that records the pH levels for a 24 to 48?hour period. Normal activity is encouraged during the study, and a diary is kept of symptoms experienced, or activity that might be suspicious for reflux, such as gagging or coughing. It is also recommended to keep a record of the time, type, and amount of food eaten. The pH readings are evaluated and compared to the patient's activity for that time period.

Treatment for GERD  

Specific treatment for GERD will be determined by a physician based on:

  • Age, overall health, and medical history
  • Extent of the condition
  • Tolerance for specific medications, procedures, or therapies
  • Expectations for the course of the condition

In many cases, GERD can be relieved through diet and lifestyle changes, as directed by a physician. Some ways to manage heartburn include the following:

  • Monitor the medications taken – some may irritate the lining of the stomach or esophagus
  • Quit smoking.
  • Watch food intake and limit fried and fatty foods, peppermint, chocolate, alcohol, coffee, citrus fruit and juices, and tomato products
  • Eat smaller portions
  • Avoid overeating
  • Watch consumption of alcohol
  • Do not lie down or go to bed right after a meal. Instead, wait a couple of hours.
  • Lose weight, if necessary
  • Elevate the head of the bed 6 inches
  • Take an antacid, as directed by your physician
  • Ask your physician about use of over-the-counter medicines called "H2-blockers" and "protein pump inhibitors." Formerly available only by prescription, these drugs can be taken before eating to prevent heartburn from occurring. Also, promotility medications which help to empty food from the stomach may be prescribed by your physician.
  • Occasionally, a surgical procedure called fundoplication may be performed to strengthen the esophagus and prevent reflux.
  • Transoral Incisionless Fundoplication (TIF) treatment  for GERD at Methodist Dallas and Methodist Richardson 

    Treatment options for GERD at Methodist Dallas and Methodist Richardson medical centers can include:  

    • Transoral Incisionless Fundoplication (TIF)
      TIF is an innovative, incisionless, minimally invasive procedure performed using the the FDA-cleared EsophyX® device attached to a standard endoscope. The endoscope is gently guided through the mouth and esophagus to the stomach. The TIF device is then used to retract and resection the fundus, using polypropylene fasteners rather than surgical incision, to create a new gastroesophageal valve.

    Methodist Dallas Medical Center and Methodist Richardson Medical Center are two of the few hospitals in the Dallas-Fort Worth Metroplex offering TIF treatment for patients with gastroesophageal reflux disease (GERD).

    Advantages of TIF

    Incisionless surgery greatly reduces the risks associated with blood loss, need for transfusions, surgical infection, and incisional herniation. Many patients go home the next day and resume normal activities within a few days. The TIF procedure offers patients:

    • Short hospital stays
    • Reduced patient discomfort
    • Quicker recovery
    • No visible scarring
    • Reversible procedure

    Not all GERD patients may be candidates for the TIF procedure. Thorough evaluation by a  gastroenterology specialist is necessary.

    Contact us

    To find a physician on the medical staff at Methodist Health System, search our online physician directory or call 214-947-0019 or toll-free 1-866-483-3922. To find a physician at Methodist Richardson Medical Center, call 972-4-DR-LINE (972-437-5463).

    The topics and content presented in the animations were provided by an independent source and were not created, edited, or the accuracy confirmed by Methodist in any manner. They are for informational purposes only. They are not intended to be a substitute for medical advice and information provided by your health care provider. Any decision you make regarding your health care options should be made after consulting a qualified physician.

    Texas law prohibits hospitals from practicing medicine. The physicians on the Methodist Health System medical staff are independent practitioners who are not employees or agents of Methodist Health System, Methodist Dallas Medical Center, Methodist Charlton Medical Center, Methodist Mansfield Medical Center, Methodist Richardson Medical Center, or any other affiliated institution.

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