Acid Reflux

Acid reflux – also known as esophageal reflux, heartburn, and gastroesophageal reflux disease (GERD) – is a common condition caused by stomach acid abnormally rising up into the esophagus.

UT Southwestern’s interventional and motility specialty gastroenterologists and gastrointestinal radiologists work closely with our GI surgeons to deliver multidisciplinary, comprehensive care when needed – all in one location, and usually on the same day.

Multidisciplinary Care for Acid Reflux

Acid reflux occurs as a result of the disturbance of the normal anatomy and physiology at the junction between the esophagus and the stomach, allowing stomach acid to back up into the esophagus.

Chronic acid reflux can lead to damage of the esophageal lining – creating ulcerations, bleeding, narrowing (stricture), swallowing problems, and Barrett’s esophagus – and can ultimately develop into esophageal cancer.

UT Southwestern’s multidisciplinary team offers advanced treatments for acid reflux, including minimally invasive and robotic procedures to treat acid reflux that has not responded to medication and lifestyle changes. Even when patients have had prior surgery, our team attempts to perform surgical procedures through small incisions to prevent or reduce reflux from occurring.

Symptoms

Symptoms of acid reflux include:

• Heartburn
• Abdominal pain
• Asthma
• Bronchitis
• Chest pain
• Chronic cough
• Dental problems
• Laryngitis or sore throat
• Regurgitation
• Swallowing problems
• Recurrent pneumonia

Contributing factors include advancing age; obesity; giving birth numerous times; smoking; coffee/caffeine and chocolate consumption; alcohol consumption; chronic consumption of large meals, especially prior to bedtime; and a family history of heartburn or reflux.

Diagnosis and Treatment

Initial efforts to treat acid reflux focus on stopping the movement of stomach contents up into the esophagus, reducing the stomach acid secretion, and improving the emptying of the esophagus and stomach.

After a thorough history and physical examination, along with a review of the available data, nearly all patients are treated successfully with lifestyle changes and medications.

When initial treatment doesn’t work, further evaluation is conducted to better understand the degree of reflux and to choose the best therapy. The following studies are often performed:

• Barium swallow study, to assess the anatomy and function of the esophagus
• Endoscopy or esophagogastroduodenoscopy with biopsies, to visualize the lining of the esophagus and evaluate for damage and other conditions such as eosinophilic esophagitis (EoE)
• Esophageal manometry, to evaluate the function of the esophageal sphincters and body of the esophagus
• EndoFlip, to evaluate diameter and distension of the esophagus, as well as presence of secondary peristalsis of the esophagus
• pH study, a measure of the degree of acid moving up to the esophagus
• Impedance study, to evaluate acid, weakly acidic and non-acid reflux, symptom correlation, number of reflux episodes, and how high in the esophagus those reflux episodes happen

Our specialized team of thoracic and pediatric surgeons, gastroenterologists, and radiologists works together to recommend the best treatment for each patient. Treatment options might include:

• Endoscopic esophageal interventions
• Minimally invasive or robotic fundoplication, or repair of hiatal hernias (using Nissen, Toupet, Dor, or Belsey techniques)
• Minimally invasive cutting-edge techniques to reduce or eliminate reflux disease (such as the LINX reflux management system)

Clinical Trials

In addition to standard treatments for acid reflux, UT Southwestern provides access to the most promising new therapies through clinical trials. Talk with our doctors to see if a clinical trial might be right for you.