Acid reflux treatments
Treats the cause of GERD, repairs hiatal hernia, paraesophageal hernia
When diet and medication no longer control chronic heartburn – also known as acid reflux and gastroesophageal reflux disease (GERD) -- acid reflux procedures may be your best option. Duke esophageal surgeons perform minimally invasive procedures that repair the underlying cause of GERD as well as hiatal hernias and paraesophageal hernias. We are also one of the only North Carolina centers to offer simpler acid reflux procedures which avoid some of the side effects of traditional heartburn surgery. These procedures ensure you experience lasting relief.
Understand your acid reflux treatment options
Untreated GERD can cause serious medical problems, including painful irritation of the esophagus called esophagitis, and strictures, which narrow the esophagus and make it harder to swallow. Untreated GERD can also cause Barrett’s esophagus, a change in in the lining of your esophagus, which has been linked to esophageal cancer. The first approach to treatment typically includes:
- Lifestyle and diet changes, which offer some relief from chronic heartburn, bloating and belching.
- Over the counter antacids and prescription medicines, including proton pump inhibitors, which reduce the amount of acid produced in the stomach. However, studies show the long-term use of proton pump inhibitors may impact your body’s ability to absorb nutrients, and increase your risk of bone fractures.
These treatment options can’t fix the underlying problem when a hiatal hernia is present, or if the cause is a weak, ineffective muscle at the bottom of your esophagus. Acid reflux procedures repair your weak esophagus muscle, as well as a hiatal hernia, which occurs when the stomach and other abdominal organs enter the chest area through the esophagus. The presence of a hiatal or paraesophageal hernia allows acid to flow freely into the esophagus and may cause additional symptoms including nausea, vomiting, chest pain, heartburn and difficulty swallowing.
New procedures treat GERD
Several procedures are available to treat GERD, and range from Stretta, which requires no incisions to a new, minimally invasive procedure called LINX, which avoids some of the side effects of traditional heartburn surgery, such as bloating or inability to vomit.
Because these procedures are relatively new, their availability is limited. Duke surgeons are among the only GERD specialists in North Carolina offering Stretta and LINX to treat acid reflux. Since not everyone is a candidate, we perform a comprehensive evaluation of your condition and recommend the most appropriate treatment for your medical needs.
Choose a surgeon who specializes in acid reflux
Advanced training, experience, and volume – meaning the number of procedures performed -- count when choosing a surgeon to treat your acid reflux.
- Duke esophagus surgeons complete advanced training in esophageal surgery as part of their thoracic fellowship training. As thoracic surgeons, their area of specialty is the chest. Advanced esophageal surgical training means they are highly skilled in major esophageal surgeries and procedures.
- As a high volume center, people are often referred to our surgeons for management of GERD and its symptoms and travel to us from nearby regions.
- Duke was the first center in North Carolina to implant the LINX device. Our surgeons have more experience performing this procedure than any other center in the state.
- We use robotic surgical technology, which provides better visualization and instrumentation, to perform advanced and complex minimally invasive heartburn surgery.
Esophagus surgeons use small incisions to surgically wrap part or all of the stomach around the lower esophagus to strengthen the muscle and stop the acid reflux. There are many ways to perform this procedure. Your surgeon will determine which procedure is right for you.
Small incisions allow your surgeon to reach the esophagus. A ring of magnetic, titanium beads is wrapped around the lower esophageal muscle. The LINX device prevents the contents of the stomach from backing up into the esophagus. It does not prevent food or liquids from moving down the esophagus into the stomach. People go home the same day or one day following the procedure.
A flexible, lighted tube called an endoscope is threaded through the mouth to reach the esophagus and deliver radio frequency waves to heat and remodel the lower esophagus muscle. This improves the muscle’s tone, and restores the natural barrier that prevents acid reflux.
If you have been diagnosed as obese, gastric bypass surgery can bring relief because the procedure removes the acid producing portion of the stomach.
If you have been diagnosed with Barrett's esophagus, your doctor will thread an endoscope with an electrode at its tip into the mouth to reach the esophagus. The electrode delivers heat energy, which destroys the diseased lining of the esophagus.
Also referred to as an esophagram, this X-ray of the esophagus allows your doctor to evaluate your degree of reflux, the shape of your esophagus, and look for a hiatal hernia.
A thin, flexible tube inserted into your mouth lets your doctor view inside your esophagus, stomach and small intestine.
A tiny electronic device inserted by catheter through the nose detects weaknesses within the esophagus by monitoring strength and patterns of muscle function.
Diagnoses reflux and its severity by measuring acid content within the esophagus.
Esophageal tissue samples or biopsies are used to monitor for esophageal cancer in people with Barrett's esophagus.