Why Choose Cedars-Sinai Marina del Rey Hospital for GERD Treatment?
At Cedars-Sinai Marina del Rey Hospital, our well-trained and experienced gastroenterologists provide patients with a wide range of innovative and effective methods to diagnose and treat GERD. Upon diagnosing the patient’s condition our specialists choose the best treatment options in order to alleviate their symptoms and underlying conditions.
Gastroesophageal reflux disease, also called GERD or acid reflux, is a common digestive condition. Symptoms include breathing problems, pain in the chest area, heartburn, a bad taste in your mouth, and even vomiting. These symptoms happen when the contents of your stomach, mainly food and gastric acid, flow up into your esophagus and irritate its lining due to a malfunction of the lower esophageal sphincter (LES). A healthy LES opens up, in order to permit the ingestion of food, and closes after that, so that the food and other stomach contents remain inside the stomach. A deficient LES fails to close, allowing for the stomach’s contents to flow back up.
Acid reflux is a common syndrome that affects more than 30% of the population. In most cases, acid reflux is not a severe condition, but when it becomes frequent it can disturb day to day activities. If acid reflux visibly damages the lining of your esophagus, doctors may diagnose you with GERD.
Although GERD can be easily treated, and is a rather mild condition, it can trigger some serious complications like the inflammation of the esophagus, also known as esophagitis; Barrett’s esophagus, a serious condition that affects the cells of the esophagus' or esophageal stricture, which consists of a narrowing of the esophagus making it difficult to ingest.
Surgical Procedures Performed at Cedars-Sinai Marina del Rey Hospital for GERD
Although gastroesophageal reflux is a condition that can generally be resolved with medications, there are instances when the doctors might recommend surgery. Surgery becomes an option for GERD when medications are ineffective, or when the patient is unable to take the required medications. There are two procedures that can treat GERD:
- Laparoscopic anti-reflux surgery: The main purpose of this surgery is to reinforce and tighten the lower esophageal sphincter in order to prevent the stomach reflux from happening. This surgery is usually done laparoscopically, which means that it is a minimally invasive procedure that requires a short hospital stay and allows for a fast recovery.
- Implementation of a LINX device: The LINX is a new and innovative device consisting of a small band, made of magnetic beads, that is placed around the esophagus, keeping it closed and preventing acid reflux from happening. The magnetic attraction between these tiny beads is strong enough to prevent stomach reflux but weak enough to allow the esophagus to open when food is ingested. The implantation of this device is done using minimally invasive surgery.
Drugs and Other Treatments Needed for GERD
Before deciding to treat GERD surgically, people generally opt for easier and less invasive treatment methods, such as different types of medications. When treating GERD, most people usually start by taking over-the-counter medications to control their acid reflux. If this type of medication is not effective, the doctors prescribe different combinations of medication or even surgery.
Some of the most common medication treatments for GERD are:
Laparoscopic anti-reflux surgery »
Implementation of a LINX device »
H2 antagonists »
Proton pump inhibitors (PPIs) »
There are two different types of GERD:
Erosive esophagitis »
Non-erosive reflux disease »
Symptoms of GERD
Some of the most common symptoms associated with GERD include:
Although GERD is a common condition and its symptoms may not always indicate an underlying condition, heartburn or pressure in the chest area should never be ignored, especially when accompanied by symptoms such as arm pain or shortness of breath, as they can precede a heart attack. It is also strongly recommended to see a doctor when any of the symptoms mentioned above persist and cannot be alleviated with over-the-counter medications.
Diagnosis of GERD
Gastroesophageal reflux disease can be diagnosed by doing one or more of the following procedures:
- Symptoms analysis: Doctors can diagnose GERD by identifying and analyzing the patient’s symptoms.
- Esophageal pH test: This procedure is performed in order to measure the levels of acid reflux and it is helpful when diagnosing GERD or when trying to evaluate the efficiency of different treatments.
- X-ray tests: An X-ray, also known as a barium swallow, is effective when diagnosing GERD as it permits the doctor to see the shape of your esophagus, stomach, and duodenum.
- Endoscopy: This procedure is performed by inserting a flexible tube equipped with a camera, through your esophagus, and into your stomach, in order to analyze their linings and to check for any signs of disease.
- Esophageal manometry: During this procedure, a thin tube is inserted through the nose, down the esophagus, and into the stomach, in order to measure the muscle contractions that result from swallowing.
Risk Factors for GERD
There are certain factors that increase a person's risk to develop GERD, such as:
- Pregnancy: The pressure exerted on the stomach by the growing fetus and the high levels of progesterone that are produced during pregnancy can be risk factors that contribute to the development of GERD.
- Smoking: This habit irritates the stomach and can contribute to the development of GERD.
- Diabetes: Patients who suffer from this condition can also develop gastroparesis, a condition which slows down the digestion, making gastric reflux possible.
- Asthma: Experts are still investigating what the correlations between GERD and asthma are. One theory indicates that in patients who have asthma, gastric reflux is a consequence of their recurrent coughing and pressure in their lungs. Another theory suggests that certain medications prescribed for asthma can weaken the lower esophageal sphincter.
- A hiatal hernia: This condition increases the chances of GERD because it weakens the lower esophageal sphincter.
- Obesity: This is a risk factor because the extra weight can cause an excessive amount of pressure on the stomach, which can result in gastric reflux.
- Peptic ulcers: These ulcers can contribute to the onset of GERD because they affect the normal digestion process.
- Connective tissue disorders: These tissue disorders can affect the gastroesophageal functions because they can contribute to the hardening of the muscular tissue.
- Zollinger-Ellison syndrome: This affection can encourage the development of GERD because it is associated with the production of high levels of gastric acid, usually due to the presence of a tumor in the small intestine or in the pancreas.
- Foods: Some people can have GERD symptoms as a result of consuming certain foods. However, food alone cannot cause GERD, but it can worsen its symptoms. Some of the foods that have been associated with GERD symptoms are carbonated drinks, caffeine based products, spicy foods, chocolate, fat foods, etc.
Causes of GERD
One of the main causes of GERD is recurrent and persistent acid and bile reflux into the esophagus. The constant presence of acid in the esophagus irritates its mucosa, thus, causing esophagitis. If not properly addressed, this affection can have serious consequences, such as Barrett’s esophagus, bleeding, or narrowing of the esophagus.
Other causes of developing GERD are:
- Constant pressure exerted on the abdominal area that can be caused by pregnancy or obesity.
- Certain medications, such as asthma medications, hypertension medications, painkillers, allergy medications, anti-inflammatories, or antidepressants.
- Being a smoker.
- Suffering from a hiatal hernia, a condition which is characterized by having a part of your stomach too far up, pressing into the chest.
The symptoms associated with GERD, such as acid reflux or heartburn, can be alleviated by using alternative medicine and treatments. However, these treatments have not been scientifically confirmed to work, and they might be harmful in certain situations, so it is strongly recommended that you ask your doctor for advice before trying any of them.
Some of the most popular alternative treatments for GERD are:
- Acupuncture: This 4000-year-old traditional Chinese medicine technique uses tiny needles to puncture certain points on the body, in order to restore the energy flow and to accelerate the healing process. According to a recent clinical trial, this technique can alleviate certain symptoms associated with GERD. Additionally, another type of acupuncture, namely electro-acupuncture is also considered efficient when dealing with GERD.
- Melatonin: This substance is normally produced in the intestinal tract and can reduce some of the symptoms that are associated with GERD, like excessive gastric acid, excessive pressure on the lower esophageal sphincter, or epigastric pain.
- Relaxation techniques: One of the factors that can increase the incidence of GERD symptoms is stress, thus, learning how to control and manage our levels of stress can help us eliminate some of the symptoms. The most popular relaxation techniques include meditation, yoga, massage therapy, and breathing exercises.
- Hypnosis: This technique, also known as hypnotherapy, has been used to treat and alleviate the symptoms of GERD. According to people who tried this technique, some of the symptoms that have been alleviated by using hypnotherapy are the pain in the abdominal area, bowel movement inconsistency, bloating, or even anxiety.
- Herbal remedies: Some of the herbs that are considered beneficial when dealing with GERD are: chamomile, ginger, slippery elm, and marshmallow root. However, there is limited research regarding these plants and their efficiency and even they can sometimes have negative side-effects, and thus, it is strongly recommended that you seek medical advice before trying any of them.
- Baking soda: This common household substance is considered effective when trying to neutralize excessive stomach acid. In order to know what the recommended dosage is, ask for a doctor’s advice.
Some of the most efficient preventive measures for GERD and its symptoms consist of certain changes in lifestyle, such as: quitting smoking, losing any extra weight, avoiding tight clothing, sleeping with your head elevated, and avoiding carbonated drinks.
Another efficient way to prevent GERD is to seek medical advice when confronted with symptoms that might indicate the presence of this condition. The doctor can then prescribe medications that can prevent these symptoms from evolving into a severe condition.
Are you suffering from gastroesophageal reflux disease? For any questions, information or guidance related to GERD treatment, get in touch with our specialty-trained, skilled gastroenterologists at Cedars-Sinai Marina del Rey Hospital.