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Gastroesophageal Reflux Disease (GERD)

Virginia Mason is recognized internationally for treatment of GI disorders, including gastroesophageal reflux disease or GERD. GERD is a common disorder affecting more than 17 million adults and children. It occurs when stomach contents and acid flush back up into the esophagus causing irritation and inflammation in the esophageal lining.

Gastroesophageal reflux disease (GERD) diagram
A band of muscle fibers, the lower esophageal sphincter, closes off the esophagus from the stomach. If the sphincter does not close properly, food and liquid can move backward into the esophagus and cause heartburn and other symptoms known as gastroesophageal disease (GERD).

Virginia Mason offers the latest, minimally invasive endoscopic procedures to diagnose and treat GERD and Barrett's esophagus. Our gastroenterologists also participate in ongoing clinical trials that offer the latest research for these and other conditions affecting the esophagus. To schedule an appointment, call (206) 223-2319.

Symptoms of GERD

Several common symptoms of GERD include:

  • Regurgitation of stomach contents and acid into the lower esophagus
  • Heartburn or a burning sensation in the throat
  • Sour taste
  • Sore throat from acid reflux
  • Chest pain
  • Difficulty swallowing

Diagnosing GERD

Your physician will first want to rule out cardiac chest pain as the cause of your symptoms. In many cases, your gastroenterologist will be able to tell, based on the symptoms you describe, whether or not you have GERD. He or she also will have you undergo one or more procedures to help diagnose your condition and determine if there is any damage to the esophageal lining from reflux. See FAQs about GERD.

AN UPPER GI

An upper GI or esophagogastroduodenoscopy (EGD) is a minimally invasive, endoscopic procedure that allows your gastroenterologist to view the esophagus, stomach and part of the small intestine. An endoscope is a thin flexible tube that contains miniaturized instruments, including a camera. Once you have been given a mild anesthetic for your throat and a sedative, your gastroenterologist will gently guide the endoscope down the esophagus and into the stomach, and take pictures that are transferred to a video monitor. Your gastroenterologist also is able to take tissue samples (biopsy).

This endoscopic procedure can help your gastroenterologist determine if you have inflammation in your esophagus (esophagitis) or stomach (gastritis), or if there is another condition that has resulted from GERD, such as a growth, a stricture (narrowing of the esophagus) or Barrett's esophagus (a precancerous condition from cellular changes to the esophageal lining).

BARIUM X-RAY

During this procedure you will drink a chalky substance that coats your throat, stomach and part of the small intestine. The liquid coating allows your gastroenterologist to see, on x-ray, abnormal areas of the esophagus, including strictures (narrowing), growths, or a hiatal hernia. This procedure is also called a "barium swallow.

ESOPHAGEAL pH MONITORING

This 24 hour-pH test or probe measures when and for how long stomach acid flows up into the lower esophagus. After first having your throat sprayed with a mild anesthetic, a thin tube is put into your nose or mouth and down the esophagus. The tube is attached to a monitor that you wear around your waist (or in your pocket) to record the level of acid activity. You will also keep a diary of your symptoms. This test is also called an ambulatory pH test.

ESOPHAGEAL MANOMETRY

An esophageal manometry study may be performed in patients with swallowing disorders. This procedure measures the strength of your esophageal contractions - which help move food toward the stomach - and whether the lower esophageal sphincter (muscle) is closing properly. After first receiving a mild anesthetic to numb the throat, a thin tube is passed into your nose and down your throat and into the stomach. The tube is connected to a monitor that records these esophageal activities. The test takes about one hour.