Most likely, you have experienced heartburn on occasion – perhaps
after eating a heavy, spicy meal. That burning sensation in your chest
can disrupt your sleep, but it’s nothing to worry about. Or is it?
“Frequent heartburn may be a symptom of a more serious condition
called gastroesophageal reflux disease (GERD), also known as acid reflux,”
says Dr. Mary Maish, chief of Thoracic and Foregut Surgery at Washington
Hospital. ”Some acid reflux is normal, and almost all people have
it occasionally. Heartburn becomes a concern, however, when it is chronic
and damages the esophagus. Anyone with frequent heartburn should see a
physician to see if testing for GERD is indicated.”
Acid reflux happens when the contents of the stomach back up into the esophagus
– the “food pipe” that leads from the throat to the
stomach. The acid flows back up into the esophagus because the valve (called
a “sphincter”) between the stomach and esophagus isn’t
working properly. This can cause symptoms of heartburn, regurgitation,
cough, hoarseness and even asthma.
To promote greater awareness of GERD’s potential complications and
treatment options for GERD, Washington Hospital will conduct a free seminar
featuring Dr. Maish on Tuesday, July 12, from 6:30 to 8:30 p.m. The seminar
will be held in the Conrad E. Anderson, MD, Auditorium in the Washington
West building at 2500 Mowry Avenue in Fremont.
Serious Complications of GERD
“If left untreated, GERD can lead to more serious complications
such as scarring and strictures (narrowing) of the esophagus, which make
it difficult to eat and swallow,” says Dr. Maish.
Another serious GERD complication is Barrett’s esophagus, which affects
approximately 3.3 million Americans, with a 2 percent risk per year of
developing esophageal cancer.
“In Barrett’s esophagus, the cells in the lining of the esophagus
change to compensate for the acid,” Dr. Maish explains. “These
cells continue to change, becoming precancerous, and perhaps even cancerous.
Esophageal cancer is not very common, however, with approximately only
16,000 cases diagnosed each year.”
Dr. Maish notes that GERD can sometimes be caused by a condition called
“With a hiatal hernia, part of the stomach slips up into the chest,
causing intermittent heartburn symptoms,” she says. “Minimally
invasive surgery can be performed laparoscopically to correct a hiatal
hernia by anchoring the stomach back down in the abdomen.”
Nonsurgical Treatment Options
In many cases, physicians recommend treating uncomplicated GERD by making
a few simple lifestyle changes, such as diet modification and weight loss,
which Dr. Maish will discuss at the seminar.
“Lifestyle changes can be hard for some people to maintain over the
long term,” Dr. Maish concedes. “For example, many people
try to change their diet and lose weight, only to fail time and again.
That can be very discouraging. So, in addition to making lifestyle changes,
people may need medications to help control GERD. These medications include
antacids, H2 blockers that block histamine receptors in the stomach, and
proton pump inhibitors (PPIs), which block acid production in the stomach.
“PPI medications are the most effective drugs for treating persistent
GERD,” she adds. ”Unfortunately, a collective group of studies
indicate that there may be some correlation between use of PPIs and increased
risks of cardiovascular disease, kidney disease, dementia and osteopenia.
If you are concerned about taking a PPI medication, consult your doctor
about whether the benefits of the drug outweigh the risks.”
Other Treatments for GERD
While lifestyle changes and medications may help alleviate the symptoms
of GERD, they don’t change the function of a loose sphincter between
the esophagus and the stomach. Improving the function of this sphincter
is important to fixing the symptoms and preventing complications of GERD.
At the seminar, Dr. Maish will discuss various procedures for strengthening
the esophageal sphincter.
The current standard surgical approach for strengthening the sphincter
is called laparoscopic Nissen fundoplication. This minimally invasive
laparoscopic surgery strengthens the lower esophageal sphincter by wrapping
the upper curve of the stomach (known as the fundus) around the sphincter.
“Laparoscopic Nissen fundoplication offers good results for most
people,” says Dr. Maish. “It requires only a one- or two-day
stay in the hospital.”
A newer minimally invasive surgical procedure to correct faulty esophageal
sphincter function involves inserting a beaded “magnetic bracelet”
over the end of the esophagus at the location of the sphincter. This device
serves to strengthen the valve and prevent symptoms and complications of GERD.
“The magnetic bracelet, known as the LINX device, wraps around the
base of the esophagus to prevent food, acid or bile from going from the
stomach back up into the esophagus,” Dr. Maish explains. “The
bracelet is a one-way valve that is flexible enough to let food go down,
but not back up.”
Dr. Maish is currently one of the very few physicians in the Bay Area placing
the LINX magnetic bracelet for GERD.
“The LINX device is extremely effective in treating GERD,”
she asserts. “Patients spend less than an hour in the operating
room, and many of them are able to go home the same day. The recovery
period is only a few days to a week. Most importantly, more than 90 percent
of the time, patients who have a LINX device inserted are able to come
off all their GERD medications.”
To register for the seminar on July 12 or to learn more about other seminars
offered by Washington Hospital, visit whhs.com and click on the heading
for “Events” at the top of the page.
If you need help finding a physician, visit www.whhs.com or the Washington
Township Medical Foundation website at www.mywtmf.com.