Thoracic Surgery

Acid Reflux Disorders / GERD

Normally, your stomach produces acid to help with digesting food. Sometimes this acid comes up through the tube that connects your stomach and mouth (esophagus) toward your mouth. If this happens, it can irritate the lining of your esophagus. This condition is called gastroesophageal reflux disease (GERD).

GERD, affects about one in five Americans. Pregnant women may be more likely to experience GERD. You may have GERD if you have a weak lower esophageal sphincter (the valve that prevents food from climbing up the esophagus from the stomach) or if the opening that separates your chest from your abdomen is loose.

If you have GERD, you might experience symptoms such as:

  • Asthma
  • Chest pain
  • Chronic cough
  • Difficulty swallowing
  • Feeling that you have a lump in your throat
  • Heartburn: a burning sensation in your chest
  • Hoarseness
  • Pneumonia
  • Regurgitation of your food

If you have GERD for a long time, you may have acid in your esophagus frequently. This can cause certain problems:

  • Esophageal stricture (narrowing of the esophagus): If your esophagus narrows, it can create scar tissue. This makes it difficult to swallow.
  • Esophageal ulcer: Sometimes stomach acid wears away tissue in the esophagus. This can leave an open sore, or ulcer.
  • Barrett’s metaplasia: This changes the tissue in the lower part of the esophagus. It is a pre-cancerous condition.
  • Esophageal cancer

Our goal is to diagnose GERD early and treat it before you have any of these complications. To diagnose GERD, we may use several approaches:

  • Upper endoscopy: We insert a thin flexible tube with a camera at one end (endoscope). This helps us see the inside of your esophagus and stomach.
  • pH probe test: We insert a probe into your esophagus and measure the amount of acid there.
  • Esophageal manometry: We insert a pressure probe into your esophagus to see how its muscles are working.
  • X-ray: After you drink a smooth chalky liquid or take a barium pill, we take X-rays. This allows us to see the lining of your esophagus, stomach, and upper intestine.

If we catch GERD early enough, we may be able to treat it with over-the-counter medications. These include antacids or H-2 receptor blockers (to lower acid production).  We also recommend these lifestyle changes:

  • Avoid foods and drinks that trigger reflux; these might include alcohol, chocolate, coffee, fatty foods, and peppermint
  • Don’t lie down after a meal
  • Eat slowly and chew thoroughly
  • Elevate your head while you sleep

We may also need to provide prescription-strength medications, such as proton pump inhibitors and medications to strengthen your lower esophageal sphincter. If necessary, we can perform surgery to tighten the esophageal muscles and prevent reflux.

Why Mount Sinai

Our esophageal cancer team works with other experts in the Mount Sinai Health System to develop a diagnosis and treatment plan that is right for you. We often work with experts from gastroenterology, otolaryngology, speech and swallowing therapy, thoracic surgery, medical and radiation oncology, and radiology.