Heartburn & Swallowing Disorders
The Hancock Regional Hospital Heartburn and Swallowing Disorders Center brings together a multidisciplinary team of specialists diagnosing and treating heartburn or acid reflux, hiatal hernia, voice disorders caused by acid reflux and other swallowing disorders.
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Although nearly everyone experiences heartburn at one time or another, some are frequent sufferers. Over 18 million people experience chronic heartburn at least twice a week. Frequent heartburn symptoms include:
- Painful burning sensation, heartburn, in the upper chest and/or stomach just below the breastbone*
- Bitter or acid taste in the mouth
- Chest pain
- Difficulty sleeping after eating
- A dry cough and/or sore throat and chronic hoarseness
- Other symptoms such as: asthma, wheezing and/or chronic cough
- Feeling of something sticking in the throat or difficulty swallowing
- Gingivitis/tooth decay or bad breath
*Even if you do not have these symptoms, severe acid reflux may still be present. Failure of antacids or other OTC medication to relieve these symptoms may indicate a more serious problem.
What is GERD?
Gastroesophageal reflux disease, or GERD, occurs when stomach contents reflux, or come back up, from the stomach into the esophagus. This can be caused by a weak or malfunctioning ring of muscle tissue known as the lower esophageal sphincter, or LES, at the bottom of the esophagus. When functioning normally, the LES opens to allow food into the stomach and closes to keep the food from going back out. When this doesn’t work correctly, acid comes back into the esophagus or even into the mouth or lungs.
Chronic heartburn, when left untreated, can lead to esophagitis (inflammation of the esophagus), scarring or narrowing of the esophagus, bleeding and ulcers, and Barrett’s Esophagus (pre-esophageal cancer).
What are risk factors for GERD?
Although a weak or malfunctioning LES can be the cause of GERD and chronic heartburn, additional risk factors may cause the condition. Simple changes in diet, losing a few extra pounds, and relieving pressure on the stomach can help provide some relief of symptoms. However, if you are a chronic heartburn sufferer, you should consult your physician to determine the best treatment plan for you.
Risk factors for Heartburn
- Diet – especially spicy, greasy, or fried foods
- Excess weight
- Exercising too soon after meals
- Drinking alcoholic, carbonated, or caffeinated drinks
- Excessive pressure on the stomach caused by frequent bending, tight clothes and even pregnancy
- Certain medications – (never discontinue any medication without first consulting your physician)
- Hiatal Hernia
Not just an adult affliction
Spitting up is common for most babies and young infants. Most babies grow out of this. However, children who spit up, or vomit, frequently after eating may be at risk for heartburn and reflux problems.
Children who have reflux typically are at an increased risk for other conditions such as asthma, dental problems, laryngitis, pneumonia, recurrent middle ear infections and sinusitis.
GERD symptoms in children include:
- Refusing to eat
- Fussiness at mealtimes
- Vomiting after eating
- Frequent coughing and/or choking, especially at night
- Frequent colds/upper respiratory infections
- Wheezing or rattling in the chest
- Waking up frequently with a sore throat
- Sour taste in the mouth
- Sleep walking
What tests are used to evaluate a person with GERD?
There are several tests available to help diagnose GERD. They are:
- Upper endoscopy – a slender scope with a light and camera is used to view, and biopsy, tissues in your esophagus and stomach.
- Esophageal Manometry Study – a small tube is inserted into the esophagus through the nose and measures the varying pressures of the esophagus when swallowing.
- Ambulatory 24-hour pH Study – a small tube is inserted through the nose and into the esophagus. It contains a small electronic recorder that monitors acid levels over a 24-hour period while you carry out your daily activities.
Using these methods, physicians can determine the extent of treatment necessary to help one alleviate GERD.
Life style changes can help.
For mild heartburn sufferers, the following changes may alleviate most heartburn symptoms. Avoiding diet no-no’s such as citrus fruits (i.e. orange juice), coffee, carbonated sodas, alcohol, spicy foods, large meals, tomato products, and chocolate will help. If you smoke, enroll in a smoking cessation class and kick the habit. Also, avoid lying down after meals for at least two hours and do not eat or drink two to three hours before bedtime.
Losing weight can help relieve abdominal pressure, thus reducing some of the severity of symptoms. As always, consult your physician before beginning any exercise program.
When life style changes are not enough.
If surgical intervention is necessary, the following treatments are available for GERD sufferers:
- Laparoscopic Nissen Fundoplication – the upper portion of the stomach, or fundus, is wrapped around the esophagus and sewn into place.
- EsophyX TIF (transoral incisionless fundoplication) is the latest treatment for safely and effectively treating chronic acid reflux disease, also known as gastroesophageal reflux disease (GERD). A completely incisionless procedure, EsophyX TIF reconstructs the antireflux barrier to provide a solution to the anatomical root cause of GERD. The procedure is for patients who are dissatisfied with current pharmaceutical therapies or are concerned about the long-term effects of daily use of reflux medications.
Changes in diet and lifestyle are always encouraged first, followed by medications, and in some cases, surgical treatment.
The Heartburn Center
At Hancock Regional’s Heartburn Center, patients are assessed, tested, and treated at one location. A clinical coordinator stays with the patient through the entire process. Most patients are diagnosed and begin treatment within one week.
We provide a multidisciplinary approach to diagnosis, treatment and management of GERD as well as other digestive disorders.
Dr. Jeffrey Heise
Board Certified General Surgeon and medical director of the Heartburn Center. He trained at Southern Illinois University School of Medicine. Advanced training in surgery was completed at Michigan State University Grand Rapids Medical Education and Research Center. He is specialty trained and certified to perform the Esophyx TIF Procedure.
Dr. Michael Myers
Completed his general surgery internship at William Beaumont Hospital in Royal Oak, Michigan, and his otolaryngology residency at the University of Michigan. He completed a research fellowship at the Kresge Hearing Research Institute and is certified by the American Board of Otolaryngology.
Dr. James Miner
Certified by the American Board of Otolaryngology. Dr. Miner is Clinical Assistant Professor at Indiana University Medical Center in Otolaryngology – Head and Neck Surgery.
Dr. Robert Klinestiver
Graduate of Indiana University Medical School. He completed post graduate training with a specialty in pulmonology at Methodist Hospital and I.U. School of Medicine. He is a Board Certified Pulmonologist, internist, and critical care specialist.
Susan Rockafellow M.S., CCC-SLP
ASHA certified speech-language pathologist with special training in swallowing disorders. She obtained her degrees at University of Michigan and University of Oklahoma Health Science Center. She is also certified to perform manometry and pH testing.
Lisa T., RN
She received her ASN degree from Ivy Tech University in 1999 and trained at the Denver Sandhill Scientific Center for reflux monitoring and motility. She is also certified to perform manometry and pH testing.
For more information
Frequent heartburn is more than a nuisance. It could be the indication of a more serious problem. For more information about GERD and treatment procedures, please call (317) 468.4664 or email Susan Rockafellow.