Gastroesophageal Reflux Disease (GERD)

If you have gastroesophageal reflux disease (GERD), the return of acidic stomach juices, food, and fluids back up into your esophagus can cause heartburn and other pains in your chest and throat. Since longstanding GERD can cause Barrett's esophagus, a precancerous condition, treating it early and efficiently is imperative. At NewYork-Presbyterian, our digestive care experts offer treatments for GERD based on the latest medical and surgical advances. Their goal is to relieve your symptoms, helping you to feel better while reducing your risk of more serious esophageal problems.

A Team of GERD Specialists

Your healthcare team includes gastroenterologists, surgeons, nurses, nutritionists and others with experience caring for people with GERD and other disorders of the esophagus. Your team will evaluate your symptoms and choose the most appropriate treatment to restore your comfort. With a range of medical and surgical options, our team works to determine which approach is best for you.

Making an Accurate Diagnosis of GERD

The first step toward treating your GERD effectively is confirming what is causing your symptoms, as other conditions can mimic GERD symptoms. Our esophageal care centers offer all of the testing needed to diagnose GERD accurately. Your doctor may initially diagnose GERD by assessing your symptoms and how well you respond to acid-reducing medications. People with more complicated GERD may undergo:

  • Upper GI (gastrointestinal) series (also called barium swallow). This test involves swallowing a liquid that can be seen on x-rays as it goes down your esophagus.
  • Esophagogastroduodenoscopy (also called EGD or upper endoscopy). A gastroenterologist uses a fiber optic instrument (scope) to see the inside of your esophagus and possibly take tissue samples of any abnormal tissue (such as Barrett’s esophagus).
  • Manometry. A way to test whether the muscles in the esophagus are functioning properly.
  • pH monitoring. A method of measuring acid exposure in your esophagus.

Nonsurgical GERD Treatments

In many cases, diet and lifestyle changes are enough to help relieve heartburn. These may include avoidance of typical food triggers, losing weight if you are overweight, avoidance of laying down immediately after eating, and tobacco cessation. If these approaches are not sufficient to relieve your GERD symptoms, your doctor may try a long-acting prescription-strength medication.

Proton pump inhibitors and H2-receptor blockers reduce the production of stomach acid.

Minimally Invasive GERD Treatments

People with GERD who cannot take medication long-term and those who do not respond well enough to these drugs may need a procedure to correct the problem. NewYork-Presbyterian surgeons and gastroenterologists have exceptional experience in the care of people with GERD using techniques that can be performed through small incisions and sometimes no incisions, resulting in faster recovery.

  • Laparoscopic Nissen fundoplication. During this procedure, your surgeon supports the weakened lower esophageal sphincter by wrapping the top portion of the stomach around the lower esophagus as a “bolster.” This allows the lower esophageal sphincter to close, eliminating acid backflow from the stomach. Our surgeons also use this approach to treat a hiatal hernia, which occurs in more than half of people with GERD cases and occurs when part of the stomach bulges into the chest cavity through an opening in the diaphragm. At NewYork-Presbyterian, we have some of the most experienced surgeons in the world performing laparoscopic fundoplication.
  • Endoscopic fundoplication. This alternative to Nissen fundoplication can be completed without any incisions. The endoscopist inserts tools through a tube placed in your esophagus to put fasteners that increase the strength of the barrier to reflux (no wrap is created).
  • Magnetic sphincter augmentation. Our doctors perform a new procedure using a ringed magnet device placed at the junction between your esophagus and stomach. The beads resemble an expandable bracelet placed below the lower esophageal sphincter through a laparoscopic incision. When you eat or drink, the esophageal pressure pushes the magnets apart, allowing for swallowing. Then the bracelet resumes its shape, once again tightening the seal between your esophagus and stomach.
  • Radiofrequency energy. Our doctors apply radiofrequency energy to heat and create scar tissue around the lower esophageal sphincter. This treatment can reduce symptoms in some patients with GERD who are not candidates for other treatments.
  • Electrical Stimulation. Our doctors are evaluating a device that applies electrical stimulation to the lower esophageal sphincter to prevent reflux. This is done by our surgeons through a laparoscopic approach.

Contact

Digestive and Liver Diseases
NewYork-Presbyterian/Columbia

212-305-1909

Center for Advanced Digestive Care
NewYork-Presbyterian/Weill Cornell

877-902-2232