Esophageal Disorders Resources & FAQs

Reflux occurs when stomach contents and acid flow back up into the esophagus causing irritation in the throat. Usually, stomach acid is confined to the stomach. But in some cases when a small valve called the lower esophageal sphincter malfunctions, acid can seep back up into the esophagus.

There are a number of causes for gastroesophageal reflux disease (GERD), including eating certain foods that trigger heartburn (chocolate, peppermint, garlic, tomatoes, citrus fruits, etc.), ingesting alcohol and caffeine, eating too much, being overweight and lying down after a meal.

Certain medications (antidepressants, beta blockers) and some medical conditions may also cause GERD. Reflux disease also is more common in people with hiatal hernia, in which a portion of the stomach protrudes up into the esophagus.

Your gastroenterologist may perform one or more tests to help diagnose your condition and determine if there is damage to the esophageal lining from reflux. These procedures include an upper GI or esophagogastroduodenoscopy (EGD), a barium X-ray, esophageal pH monitoring and esophageal manometry.

In many people, mild symptoms of reflux disease are treated effectively with over-the-counter medications, such as antacids that neutralize the effects of stomach acid. However when these drugs no longer work, other medications, including prescription-strength H2 blockers and proton pump inhibitors, may be prescribed to reduce gastric (stomach) acid production.

In some cases, surgery is recommended when medications are no longer tolerated or effective. Surgery also may be needed to repair the esophagus to help reduce or eliminate GERD symptoms.

Most people find successful reduction of GERD symptoms with medical therapy. But sometimes medications no longer work or are not well tolerated. In these cases, surgery may be recommended to tighten the lower esophageal sphincter (LES) or to repair areas of the esophagus. Your gastroenterologist and surgeon will talk to you about the type of surgery best suited to your needs.

Long-standing GERD can lead to a precancerous condition called Barrett's esophagus, in which cellular changes have taken place in the lower esophageal lining. This condition can progress further into low- or high-grade dysplasia, and then to esophageal cancer. For this reason, people diagnosed with Barrett's esophagus are monitored regularly with endoscopic surveillance and biopsy.

Barrett's esophagus is a condition in which the cells of the lower esophagus begin to change due to the longstanding effects of gastroesophageal reflux disease or GERD. These changes, occurring over time, cause the cells in the lining of the lower esophagus to look more like cells in the intestine. The change in cellular structure is a precancerous condition and is should be monitored carefully with endoscopic surveillance and biopsy.

Barrett's esophagus itself has no symptoms, and some individuals with GERD may be unaware hat they have Barrett's esophagus. Symptoms of gastroesophageal reflux disease (GERD) include heartburn, a sour taste in the mouth from regurgitated stomach contents and acid, and a burning sensation at the back of the throat.

Barrett's esophagus is diagnosed using an endoscope—a thin flexible tube containing miniature instruments, including a camera—and a tissue sample. After receiving a mild sedative, a gastroenterologist gently guides the endoscope down the esophagus and takes images that are then transferred to a video monitor. Your doctor also will take a tissue sample for examination by pathology. This procedure is called upper gastrointestinal endoscopy (upper GI) with biopsy or esophagogastroduodenoscopy (EGD) with biopsy.

Barrett's esophagus is monitored regularly with endoscopic surveillance and biopsy to determine if additional changes have occurred within the Barrett's segment. If the biopsy shows low-grade or high-grade dysplasia (more precancerous changes in cells), your gastroenterologist will recommend a procedure to remove the diseased tissue.