Gastroesophageal Reflux Disease
Gastroesophageal reflux disease (GERD) is a common disorder which is characterized by the excessive backflow of stomach contents into the esophagus. Patients with GERD can experience a variety of symptoms including heartburn, regurgitation, acid indigestion and a bitter or sour taste in the mouth. They may also experience less typical symptoms such as a chronic sore throat, chronic cough, hoarseness, asthma and chest pain.
One of the long-term complications of GERD is a condition known as Barrett's esophagus. This disorder is characterized by the replacement of normal esophageal lining cells with intestinal cells. Because these intestinal cells may sometimes develop into cancer, patients with Barrett's esophagus should undergo periodic surveillance examinations of the esophagus. Dr. Lambroza is currently participating in a clinical study examining the effects of Polyphenon E (a green tea extract) in patients with Barrett's esophagus.
There have been dramatic advances in the medical and surgical treatment of GERD in the last twenty years. The proton-pump inhibitors (Prilosec, Nexium, Prevacid, Aciphex, Protonix, Zegerid and Dexilant) are potent acid-suppressing drugs which have helped many patients who were previously refractory to medical therapy. Patients with GERD who are responding poorly to medication, or who wish to avoid taking drugs, may be candidates for a surgical fundoplication. In this procedure, a portion of the stomach is wrapped around the esophagus in order to tighten the lower esophageal sphincter (the muscle responsible for preventing reflux). This procedure can now be performed through a laparoscopic, minimally-invasive approach which dramatically reduces the discomfort and recuperative time of the operation. Most patients considering surgery should undergo esophageal motility and ambulatory pH studies to determine whether the surgery is indicated and, if so, what type of operation should be performed.