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.

Do you have a problem?

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
• Regurgitation
• 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
• Smoking
• 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
• Stress

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
• Stomachache
• Vomiting after eating
• Hiccups
• Belching
• 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

Click here to view a March 2003 news segment by WRTV-TV on "GERD in Children" featuring Hancock Regional Hospital.

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:

The Stretta Procedure – a minimally invasive outpatient procedure. A catheter is placed into the valve between the stomach and esophagus. Controlled levels of radiofrequency energy are delivered to the LES muscles and uppermost part of the stomach. 

Laparoscopic Nissen Fundoplication – the upper portion of the stomach, or fundus, is wrapped around the esophagus and sewn into place.

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.

Staff

Dr. Jeffrey Heise is a 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.

Dr. Cam Gabrielsen is a Board Certified General Surgeon. He trained at Taylor University and Indiana University Medical Center. He also trained at St. Mary's Hospital in Grand Rapids, MI. He is specialty trained and certified to perform the Stretta, an endoscopic procedure used in the treatment of acid reflux disease. He has a special interest in oncology surgery. He has performed laparoscopic anti-reflux surgery for over 10 years. He is a fellow of the American College of Surgeons, member of SAGES, Society of General Surgeons, and American Society of Laparoscopic Surgeons. 

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 is 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 is a 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.

Tom Franceschini MS, CCC, SLP, is an ASHA certified speech-language pathologist with special training in swallowing disorders. He obtained his degrees at Illinois State University. He 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 317-468-4660, or email Tom Franceschini.