Gastroesophageal reflux disease (commonly called GERD) is a disorder of abnormal backwash of stomach contents into the chest or throat. Estimated to affect as many as 100 million people in the United States, GERD can cause garden-variety heartburn, or other symptoms such as nausea, upset stomach, painful swallowing, chest pain, or even hoarseness, coughing or throat-clearing. Although antacids may provide some symptom relief, GERD may hide much more-serious problems. Blount Memorial board-certified cardiothoracic surgeon Dr. Jason Budde explains.
“If GERD is either not controlled with medications, or comes back strongly after stopping them, the patient should see an expert such as a gastroenterologist, ENT doctor [ear, nose and throat] or surgeon, such as myself,” says Budde. “Persistent GERD can be a setup for many long-term medical problems. If the patient experiences aspiration—where stomach contents wash back up and leak down into the windpipe—the lungs may become scarred. Meanwhile, years of untreated acid will burn the esophagus [swallowing tube], which has several harmful effects.”
According to Budde, GERD-related damage to the esophagus commonly causes swallowing problems (which could be irreversible if treatment is delayed), and also can lead to esophageal cancer.
He adds, “The incidence of esophageal cancer in the U.S. is growing faster than all other cancer types, and this rise is due entirely to untreated GERD. Precancerous changes—known as Barrett’s esophagus—must be followed very closely in order to catch any cancers at an early stage.”
Patients with GERD also may experience more sudden problems. In about one quarter of GERD cases, Budde explains, the patient has a hiatal hernia—where the stomach bulges up into the chest—and these hernias usually grow over time. Left untreated, a large hiatal hernia quickly can develop a serious stomach blockage, which can be fatal without emergency surgery.
Staying healthy with GERD, Budde adds, requires three key steps:
1. Ask your health care provider for further evaluation, such as esophageal pH (acid-base) testing or manometry (pressure-testing), when medicines and diet changes do not provide relief.
2. Follow up closely when diagnosed with Barrett’s esophagus to help prevent a treatable early cancer from becoming an advanced, untreatable condition.
3. Have hiatal hernias evaluated early for surgical repair to avoid emergencies.
“Blount Memorial offers surgical management for the spectrum of GERD and esophageal cancer conditions,” Budde says. “GERD patients will require surgical therapy in about 30 to 40 percent of cases, or even more often when they have a large hiatal hernia. With minimally invasive techniques and hospital stays of two days or less, long-term satisfaction rates exceed 90 percent. As for cancer cases, we use the latest technologies to treat our patients.”