Memphis Gastroenterology Group, Inc.

Many people know the feeling. A burning sensation in the upper abdomen or beneath the breastbone, the sensation of food or liquids coming back into the esophagus. Is this just heartburn or is the heartburn itself a symptom of something more serious? Gastroesophageal Reflux Disease (GERD) refers to the backward flow of acid from the stomach up into the esophagus or swallowing tube. While usually just a symptomatic nuisance, it can lead to life-threatening complications. Extremely common in the United States, GERD partially results from our poor diets and lifestyles. Almost half of us experience symptoms of GERD at least monthly and about 30 million suffer daily.

Start with Symptoms

The most typical symptoms of GERD include the familiar heartburn - a burning sensation in the upper abdomen or beneath the breastbone, and regurgitation - the sensation of food or liquids coming back into the esophagus. Beyond those, GERD may cause atypical symptoms, or with severe GERD, alert symptoms indicating complications like cancer:

Symptoms of GERD*

• Typical - Heartburn and Regurgitation
• Atypical - Chronic cough, hoarseness, asthma, sinusitis
• Alert - Chest pain, difficult or painful swallowing, nighttime coughing or choking, vomiting blood or passing black, tarry bowel movements

Self-Treatment of GERD*

• Avoid fatty foods, caffeine, alcohol, peppermint, spicy and acidic foods
• Stop smoking
• Reduce weight if overweight
• Avoid eating or drinking anything within 2 -3 hrs before sleep
• Avoid going to sleep at least 3 hrs after a heavy meal
• Elevate the head of the bed 6-8” if you have any night time symptoms
• Take over-the-counter antacids or acid blocking medications

*From the American College of Gastroenterology (www.acgi.gi.org) Patients should see a doctor for atypical symptoms or for typical symptoms that appear for the first time after age 40 or require medications more than twice per week for relief. Patients with alert or severe symptoms should seek immediate medical attention.

What is Barrett’s Esophagus?

Barrett’s esophagus (BE) is a pre-cancerous condition caused by chronic GERD and affects an estimated 3.3 million Americans. Each year, one in every 200 people with BE will develop cancer of the esophagus, the fastest rising cancer in the U.S. Those who experience even typical symptoms for longer than five years are at risk for developing BE. Caucasian males over age 50 with chronic GERD are at the greatest risk for developing BE, with 13 percent diagnosed with BE.

Diagnosis and Treatments

Mild, typical symptoms can be treated effectively with lifestyle changes, antacids and over-the-counter acid blocking medications. Primary care physicians may prescribe stronger and suppressing drugs. Patients with atypical, alert or poorly responsive symptoms should see a gastroenterologist for specialized tests to assess the severity of the disease, including testing for cancer and Barrett’s esophagus. The diagnosis of Barrett’s esophagus is made by endoscopy. Once the diagnosis is made, patients with BE should have regular, periodic endoscopic exams to monitor for dysplasia, cellular changes which suggest cancer is more imminent. These changes have traditionally warranted surgery to remove part of the esophagus. The good news is a new, non-surgical treatment to remove the precancerous cells of BE now exists. This out-patient treatment performed in conjunction with endoscopy is called Barrett’s ablation. It is performed with HALO technology which delivers heat in a very precise, highly-controlled manner to destroy the Barrett’s cells without damaging the normal tissue. This allows the esophagus the opportunity to line itself with normal cells. More information about this newest innovation is available at www.barrx.com

– Edward Cattau, M.D., FACP, FACG

Memphis Gastroenterology Group’s mission is to provide the highest quality, most cost-efficient gastroenterology services to our patients. To accomplish this goal, we will have physicians of unsurpassed ability, an endoscopy center equipped with the finest state-of-the-art equipment, a clinical staff delivering the highest quality care in a comfortable, safe, and confidential environment; and an office staff who will offer helpful and compassionate services with patient satisfaction as their first priority.