The Medical Minute: Getting to the Heart of Heartburn ? What to Know, How to Treat It

Woman suffering from acid reflux or heartburn

One in five Americans suffers from gastroesophageal reflux disease (GERD), commonly known as acid reflux. It’s a digestive disorder in which acid backs up from the stomach into the esophagus, often causing painful symptoms such as burning in the chest, abdominal pain, bloating and difficulty swallowing.

Anyone can develop GERD, a condition that occurs when the muscles that keep the end of the esophagus closed weaken. This allows the contents of the stomach to flow back up through the esophagus. The most common symptom of GERD is heartburn, which is caused by the backflow of stomach acid.

“It’s a very common disease caused by anything that increases intra-abdominal pressure like pregnancy and obesity,” said Dr. Margaret Riccardi, a minimally invasive surgeon at Penn State Health St. Joseph Medical Center. Left untreated, GERD will continue to cause discomfort and possibly lead to more serious conditions, including esophageal cancer, she said.

Riccardi discusses GERD and its treatments, including a new, minimally invasive procedure called the LINX Reflux Management System.

What causes acid reflux?

It’s basically anything that causes a weak valve between the esophagus and the stomach, whether that’s a general weakness or a hiatal hernia.

What are the symptoms?

Symptoms of acid reflux disease often include heartburn or substernal burning and regurgitation of food or fluid. The more atypical symptoms are hoarseness, chronic cough or throat clearing, and recurrent pneumonia, if there’s aspiration (when food or liquid enters the lungs). Some people have symptoms like feeling full quickly after eating or trouble swallowing,

How is it traditionally treated?

Over-the-counter medications treat GERD by neutralizing stomach acid, while prescription medications, such as proton pump inhibitors and H2-receptor blockers, decrease stomach acid. I often advise patients to avoid acidic or fried foods.

What’s the new procedure to treat GERD?

LINX is a minimally invasive procedure that uses a small band of magnetic titanium beads placed around the lower esophagus to restore the body’s natural reflux barrier. It may be a good option for patients who don’t find relief from their symptoms through lifestyle changes and want to stop taking medications. We began using the LINX procedure at St. Joseph Medical Center about one year ago.

How does LINX work?

The band of magnetic titanium beads keeps stomach acid from backing up into the esophagus. It’s designed so swallowing breaks the magnetic bond and allows food and liquid to pass into the stomach normally.

How long does the LINX procedure take, and does it cause any side effects?

LINX is a laparoscopic outpatient procedure and takes about 90 minutes to 2 hours, depending on the patient. The procedure is permanent, with few side effects, and requires minimal follow-up, other than the standard postoperative visit and a checkup a year later.

The most common side effect is trouble swallowing because the device needs to adjust to opening and closing. I advise patients to follow a special diet where they eat more frequently. After about six weeks, they usually have no issues.

What’s the success rate so far?

The success rate for patients getting off medications and free from acid reflux following the LINX procedure is about 90%.

What are the risks if GERD is not addressed?

GERD can damage the lining of the esophagus, which can start out just as esophagitis, an inflammation of the esophagus, then cause the esophagus to narrow, called an esophageal stricture. GERD can also increase the risk for Barrett’s esophagus, which is a precancerous lesion, and esophageal cancer.

Talk to your primary care physician if you have acid reflux concerns or contact Penn State Health General Surgery at 610-378-7900 to learn more about the LINX procedure.

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The Medical Minute is a weekly health news feature produced by Penn State Health. Articles feature the expertise of faculty, physicians and staff, and are designed to offer timely, relevant health information of interest to a broad audience.

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