Heartburn Center

When acid reflux dominates your life, it permeates every aspect of your daily routine, from basic functions like sleeping and working to exercising and sharing meals with loved ones. What comes next for you, and is there a viable alternative or solution?

Cumberland Bariatric Institute provides extraordinary care for patients struggling with heartburn, acid reflux and gastroesophageal reflux disease (GERD). 

We specialize in the safe and effective resolution of acid reflux. Our dedication lies in mastering the intricacies of GERD management and treatment. We aim to diagnose and eliminate the problem rather than merely alleviating symptoms. Our commitment extends until we've thoroughly understood all your symptoms and their root causes, delivering results that bring reliable and enduring relief from acid reflux.

• What is GERD?

  GERD, or gastro-esophageal reflux disease, is the result of a weak muscle within the esophagus, called the lower esophageal sphincter, which acts as a reflux barrier within the body. When functioning correctly, the barrier acts as a one-way valve that allows food to flow into the stomach and prevents stomach contents from flowing back up into the esophagus. However, people who experience GERD have a barrier that does not function properly, allowing acid and bile to flow back into the esophagus.

  GERD is also known as acid reflux disease. Heartburn is a burning sensation below the breastbone area. Heartburn is a common symptom of GERD.

• What are GERD symptoms?

  Heartburn is a common symptom that affects about 20 percent of Americans. However, it is a key symptom and indicator of GERD, especially if your heartburn:

  • Occurs twice or more a week
  • Affects your sleep
  • Persists and becomes more severe
  • Has occurred regularly for several years

  GERD exhibits significant variability among individuals, manifesting with diverse symptoms triggered by different factors and occurring at various times throughout the day. While heartburn remains the classic indicator of acid reflux, its severity may escalate to chest pain. The impact of acid reflux can extend to the upper esophagus and neck region, resulting in a sour taste in the mouth, a sore throat, a dry cough, and hoarseness. Additional symptoms encompass the regurgitation of food or acid during actions such as hiccupping, burping, bending over, or lying down. It's crucial to treat certain "Alarm Symptoms" seriously, such as difficulty swallowing, which may indicate esophageal cancer, or chest pain associated with a developing cardiac event.

• What causes GERD?

  Under normal circumstances, the stomach generates acid to facilitate the digestion of food. GERD arises when the valve, known as the lower esophageal sphincter, loses its capacity to act as an effective barrier between the stomach and esophagus. The reflux of acid into the esophagus leads to the discomforting and painful burning sensation commonly known as heartburn. Additional factors contributing to acid reflux encompass compromised esophageal motility and delayed gastric emptying, a condition referred to as gastroparesis.

• What are GERD risk factors?

  Risk factors of GERD may be caused by anything that causes extra pressure on the stomach and diaphragm, such as:

  • Being overweight
  • Performing jobs that require stooping, bending or heavy lifting
  • Being 40 years old or older
  • Pregnancy
  • Diabetes
  • Smoking
  • Diet
  • Certain lifestyle choices, including a diet of alcohol, citrus, caffeinated beverages, tomato-based foods, chocolate, spicy food, and peppermint

  When the valve is slightly compromised, individuals may only experience mild reflux. As the lower esophageal sphincter weakens, the frequency of reflux symptoms tends to increase. This creates a vicious circle where increased reflux weakens the valve even further.

• Testing for GERD
  • 24-hour Esophageal pH Monitoring. This test is the best way to confirm reflux. A 24-hour pH monitoring system uses a small tube passed through the nose or mouth, down the esophagus and into the stomach. The tube remains in place for 24 hours and monitors the amount and frequency of stomach acid that backs up into the esophagus.

  • Barium Swallow Exam. This exam involves a series of X-rays of the esophagus, stomach and the first part of the small intestine, called the duodenum. The X-rays are taken before and after drinking a contrast material called barium, a thick, white, chalky, milkshake-like liquid. The barium coats the inside lining of your digestive tract, making it more visible on the X-ray. The barium swallow exam shows if you’re experiencing reflux. It also reveals issues such as Hiatal hernias.

  • Endoscopy. EGD (Esophagogastroduodenoscopy) is a procedure that examines the esophagus, stomach and the first portion of the duodenum (small intestine) using a long flexible tube with a camera at the end of it. This allows your surgeon to see any irritation or changes to the esophagus, stomach or duodenum. This is performed under anesthesia and you will need someone to drive you home.

  • BRAVO pH Test. The BRAVO pH test measures the amount of acidity (pH) in the esophagus. For this test, your surgeon will adhere a small recording device called a BRAVO capsule to the esophagus to monitor how much acid is flowing backward from the stomach. This is done under anesthesia during your EGD.

  • EndoFLIP Impedance Planimetry System. EndoFLIP® is an advanced balloon dilation technology used during endoscopy.  EndoFLIP is an advanced technology used to measure the pressure and size of gastrointestinal organs. It can reveal how solid and strong the walls of the organ are.

    Using the EndoFLIP impedance planimetry system, gastroenterologists are able to help further the diagnosis of those with dysphagia, or persistent difficulty swallowing. A range of conditions can cause dysphagia, including esophageal motility disorders, which happen when esophageal muscles aren’t working correctly. This affects how food and liquids move from the mouth to the stomach. It often mimics the symptoms of GERD, including frequent heartburn, sore throat, and regurgitation. For those who suffer from dysphagia, an upper endoscopy (EGD) alone often is not enough to gain a diagnosis.

    Our digestive health physicians work together to help patients diminish episodes of discomfort, including:

    • Chronic cough
    • Chronic heartburn
    • Difficulty swallowing
    • Noncardiac chest pain
    • Postsurgical esophageal symptoms

    Diagnosis and treatment may include a combination of medication, lifestyle changes, endoscopic therapies, and, when appropriate, surgical procedures.