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Doctors for Gastroesophageal Reflux Disease (GERD)
Gastroesophageal reflux disease (GERD) is a common yet chronic digestive condition in which the stomach's contents sometimes flow back up into the esophagus — the tube that carries food from your throat into your stomach.
A ring of muscle called the lower esophageal sphincter (LES) normally keeps the top of your stomach closed. It relaxes and opens when you're swallowing. GERD happens when the LES relaxes and opens up when you aren't swallowing. This allows your stomach contents to flow back up the esophagus.
Other synonymous terms:
- Acid indigestion
- Acid reflux
- Acid regurgitation
Why Choose Cooper for GERD Treatment
At Cooper University Health Care, we are committed to stopping GERD in its tracks and preventing the symptoms and complications that can impact your quality of life. From simple forms of reflux to the most complicated cases, our highly trained, board-certified specialists offer state-of-the-art diagnoses, medical treatments, and surgical interventions that are tailored to meet your unique needs.
We offer a variety of advanced diagnostic tests as well as an array of treatment options that range from medications and lifestyle modifications to innovative surgical techniques. Cooper University Health Care recently became the first health system in South Jersey to implant the LINX® Reflux Management System device to help keep the lower esophageal sphincter muscle closed after eating or drinking. And our surgeons are among the most experienced in the fundoplication procedure, which provides support for the lower esophageal sphincter muscle so it can close tightly and prevent stomach acid from backwashing into the esophagus.
Our specialists perform more than 250 esophageal manometries and pH studies each year to determine how well the esophagus is working. We also perform up to 25 esophagectomies and 50 foregut surgical procedures every year.
In addition, Cooper’s Esophageal Motility Center serves as a referral center for area gastroenterologists who are not equipped to handle complex GERD and its related complications. Our Aerodigestive Center specializes in treating refractory GERD using an integrated approach that includes gastroenterologists, cardiothoracic surgeons and bariatric surgeons.
Our integrative approach means you receive the most personalized and quality care available.
What Are Symptoms?
The following are possible symptoms of GERD:
- Heartburn – burning sensation or pain in the chest that can radiate to the jaw, caused by gastric acid refluxing into the esophagus
- Regurgitation – backflow of partially digested food and gastric contents into the mouth
- Sore throat
- Dysphagia – difficulty swallowing, or the feeling that food is “stuck” in the esophagus)
- Globus – feeling of a “lump in the throat”
- Bad breath – from regurgitation
- Dyspepsia – burping, nausea after eating, bloating, upper abdominal pain and discomfort, etc.
GERD symptoms can occur in various situations, including:
- After eating a meal – a common time for people to experience symptoms, since the stomach produces acid after you eat
- When bending over or lifting a heavy object – occurs as the “valve” in the lower esophagus that prevents acid regurgitation is sometimes weak. Lifting objects or bending over can increase the pressure on your stomach, which can cause more regurgitation through thee weak valve
- When lying down, especially on your back – occurs for the same reason as bending or liftin
- At night – occurs for the same reason as lying down
- During pregnancy – GERD during pregnancy is secondary to hormonal reasons that make the valve in the lower esophagus weaker. Also, the fetus can put increased pressure on the stomach, which in turn can cause a backflow of gastric acid into the esophagus
What Are the Causes and Risk Factors?
There are many risk factors associated with gastroesophageal reflux disease (GERD), including:
- Being overweight
- Consuming alcoholic, caffeinated or carbonated beverages
- Eating certain foods such as chocolate, citrus fruits, onions, peppermint, tomato, or spicy or fried foods
- Eating large meals
- Eating right before going to bed
- Lying flat after eating
- Having a hiatal hernia
- Taking certain medicines, including aspirin and certain drugs for asthma, high blood pressure, allergies, depression, sleep disorders and pain
- Being pregnant
In addition, another cause includes the weakening or relaxation of the lower esophageal sphincter from these risk factors.
GERD Diet: What to Eat and What to Avoid
One should avoid foods in the high-acid column and eat the low-acid foods. The list of high-acid foods below are common acid reflux triggers.
|Low-Acid Foods||High-Acid Foods|
Citrus fruits - orange, grapefruit, lemon
|Meat||Chicken - skinless
Ground beef - lean
Steak - lean (tenderloin, sirloin tip)
Ground beef - full fat
Sausage - pork
Steak - high fat (marbled)
|Dairy||Cheese - feta, goat
Cottage cheese - low fat or fat free
Cream cheese - low fat or fat free
Milk (< 1%)
Sour cream - low fat or fat free
Milk - whole
|Grains||Bread - multi-grain
|Macaroni and cheese
Pasta with tomato or cream
|Beans and Nuts||Almonds
|Fats, Oils, and Condiments||Mayonnaise - fat free
Salad dressing - low fat or fat free
Salad Dressing – Creamy, full fat,
oil and vinegar
|Desserts||Cookies - fat free
Sherbet - non-citrus
|Macaroni and cheese
Pasta with tomato or cream
Cookies - fat free
Tortilla chips - fried
Hot sauce - cayenne and jalapeno
While GERD isn’t a life-threatening condition, if left untreated it can result in complications, including:
- Esophageal stricture – a narrowing of the esophagus that happens when damage from stomach acid causes a buildup of scar tissue. It can cause problems with swallowing.
- Esophageal ulcer – an open sore in the esophagus caused by tissue damage from stomach acid. It can lead to pain, bleeding and problems with swallowing.
- Barrett’s esophagus – a precancerous condition in which the cells lining the esophagus change. Barrett's esophagus is associated with an increased risk of developing esophageal cancer. Although the risk is small, it’s important to have regular checkups for precancerous cells (dysplasia). If precancerous cells are discovered, they can be treated to prevent esophageal cancer.
- Esophageal cancer – can result from years of untreated GERD. It is more common among men and is often diagnosed when it is in an advanced stage. In later stages, esophageal cancer can be treated but rarely can be cured.
- Esophagitis – irritation and inflammation caused by stomach acid that can cause ulcers, heartburn, chest pain, bleeding and difficulty swallowing
There are a number of diagnostic tools used to detect gastroesophageal reflux disease (GERD), including:
- Upper gastrointestinal GI endoscopy and biopsy – involves using a camera and light through the mouth and throat to look at the lining of GI tract and sampling small bits of tissues for examination
- Upper GI series – x-rays of GI tract that detect related anatomic problems such as strictures or hiatal hernia
- pH test – esophageal pH and impedance monitoring and Bravo wireless monitoring
- Esophageal manometry – tests the function of the esophageal body and lower sphincter (“valve”) to help diagnose issues with the structure and movement of the esophagus
Make an Appointment with a GERD Expert
Make an appointment with a Cooper specialist if you have GERD and are still experiencing acid reflux more than twice a week after making dietary changes.