Americans drink an average of 3.1 cups of coffee each day. Yet for many, this common morning pick-me-up beverage results in painful heartburn, indigestion and gastroesophageal reflux disease (GERD). “For some individuals, beverages, like coffee and orange juice, as well as certain foods, such as chocolate and pizza, may be the triggers that cause GERD,” says Atif Iqbal, M.D., medical director of the Digestive Care Center at Orange Coast Medical Center.
GERD affects some 30 million people in the United States, yet it is surprisingly under-diagnosed.
Many people simply accept the burning sensation and acid reflux as “normal.” Antacids, and other readily available over-the-counter medications allow for patients to self-treat on a daily basis, and live with the discomfort until it goes away.
“What patients don’t realize is that GERD is a serious digestive disorder that needs to be managed by medical professionals,” says Dr. Iqbal. “Left undiagnosed or untreated, it can have long term complications.”
Prolonged exposure to the stomach’s strong acids may progress from occasional irritation to chronic inflammation, esophageal ulcers, bleeding, scarring and a narrowing of the esophagus. Other dangerous complications include scarring of the lungs, and cancer of the esophagus or larynx.
LES MEANS MORE
GERD can affect people of all ages, but the likelihood increases after age 40. Risk factors include poor diet, obesity, diabetes, smoking and pregnancy. Those with a hiatal hernia are also more likely to develop GERD.
Most commonly, these risk factors contribute to a malfunction of the lower esophageal sphincter (LES), a muscular, one-way valve that allows food to move downward from the esophagus into the stomach. When the valve is compromised, food flows back up into the esophagus, bringing with it the stomach’s powerful digestive acids.
Lifestyle and dietary modifications are often the first-line treatment for GERD. Simple strategies such as avoiding trigger foods, eating smaller portions and elevating the head while sleeping provide patients with mild to early moderate GERD with much needed relief. Prescription and over-the-counter medications are also available, yet Dr. Iqbal cautions about persistent use of these agents.
“Unfortunately with GERD, over-the-counter medications may actually mask the symptoms that are indicative of the underlying problem, or something more serious,” he shares. “In the last 10 years, there has been a 600 percent increase in the incidence of esophageal cancer. It’s one of the most aggressive cancers. But with early diagnosis, we can take the needed steps for prevention.”
HELP IS HERE
The good news is that patients with mild, moderate and severe GERD have access to sophisticated diagnostic techniques and advanced treatment options at the Digestive Care Center at Orange Coast Medical Center. Here, specialists use two proven, comprehensive studies to diagnose GERD before determining the best course of action. The first is an upper endoscopy, where a thin, flexible tube equipped with a light and camera – an endoscope – is gently guided into the patient’s esophagus. Through the endoscope, physicians can see and evaluate the damage resulting from acid reflux. The second is the Bravo capsule study.
“In the 5-minute Bravo procedure, a tiny gel-capsule sized wireless transmitter is temporarily attached to the wall of the patient’s esophagus,” explains Dr. Iqbal. “The patient goes home, and returns 48 hours later. We’re able to measure how often the stomach contents reflux into the lower esophagus, and how much acid the reflux contains.”
Once an accurate diagnosis is made, for some patients, surgery may be necessary. When surgical intervention is required, Dr. Iqbal and his expert team perform minimally invasive procedures in a state-of-art facility to help rid patients of the burden of GERD. GERD surgery (fundoplication) uses robotic-assisted technology for improved outcomes, and faster recovery times, while the recent advancement of LINX, where a flexible titanium bracelet with a core of magnetic beads encircles the malfunctioning LES and keeps it closed, allows for food to go down and stay down.
“With LINX, reflux is gone immediately. Patients who have not been able to sleep lying straight in bed for several years can finally lie down and sleep normally,” says Dr. Iqbal. “Thanks to current treatments, 98 percent of surgical patients are cured of their GERD.”
For more information, please call the Digestive Care Center at Orange Coast Medical Center at (714) 378-7664. For more information on GERD and recent advances such as LINX, listen to Dr. Iqbal’s podcast, or visit our section on Digestive Care.