Foregut (esophagus and stomach) Disorders

If you suffer from conditions of the esophagus and stomach such as acid reflux, GERD, swallowing disorders, or hiatal hernias, Providence Digestive Health Institute can help. Our team provides expert care for all diseases of the esophagus and stomach. We will partner with you to help manage your condition and provide the most appropriate and effective treatments.

Heartburn, Acid Reflux and GERD

GERD is a condition that causes stomach contents to back up, or “reflux,” into the esophagus, causing heartburn, vomiting or pain when swallowing. If you suffer from heartburn more than two or three times a week, over time, it can cause GERD (gastroesophageal reflux disease), a serious form of acid reflux. If left untreated, this condition can damage the lining of the esophagus and can increase the risk of developing a more serious condition or even esophageal cancer.

Treatment options for GERD

Most people can manage GERD with lifestyle changes, such as avoiding caffeinated or acidic beverages and lying down soon after having a meal. Others may require medicines to help reduce symptoms. Your primary care provider or a gastroenterologist can help you decide what treatment is best for you.

But, if medication or lifestyle changes haven’t helped, it may be time to see a foregut specialist. Our experts can help create a personalized treatment plan to get your symptoms under control.

Conditions We Treat Treatments Why Choose Providence

Conditions We Treat

Gastroesophageal reflux disease (GERD) and hiatal hernia is a condition that causes stomach contents to back up, or “reflux,” into the esophagus, causing heartburn, vomiting or pain when swallowing.
Paraesophageal hernia (PEH) occurs when part of the stomach moves into the chest next to the esophagus, putting the stomach at risk for twisting, obstruction and constriction of its blood supply.
Achalasia, gastroparesis and other motility disorders are problems that prevent food from traveling properly through the gastrointestinal (GI) tract.
Esophageal and stomach cancer is the most rapidly rising GI cancer in the U.S. Like many cancers, it can be cured if caught early. When cancer is diagnosed, we work closely with the team at Providence Cancer Institute to develop the best treatment plan for each patient.

Treatments

Providence Digestive Health Institute is a leader in innovative endoscopic procedures. Here are just a few of the advanced procedures to treat complex foregut conditions:

Per-oral endoscopic myotomy (POEM)
This incisionless procedure uses heat to permanently relax and open the esophagus.
Laparoscopic fundoplication
This surgery for hiatal hernias and advanced GERD uses part of the stomach to strengthen the valve between the esophagus and stomach.
Minimally invasive esophagectomy
Esophagectomy is an operation to remove and reconstruct all or part of the esophagus.
Barrx ablation for Barrett’s esophagus
This endoscopic procedure uses heat to treat Barrett's esophagus by destroying abnormal cells before they can become cancerous.
Cryotherapy for Barrett’s esophagus
This endoscopic technique treats Barrett’s esophagus by exposing diseased tissue to extremely cold temperatures.
Confocal laser endomicroscopy for diagnosing Barrett’s esophagus and esophageal cancer
This procedure uses a high-powered microscope at the end of an endoscope to give real-time information that can be used to guide immediate therapy decisions.
Endoscopic Mucosal Resection (EMR) & Endoscopic Submucosal dissection (ESD)
These endoscopic procedures are advanced therapeutic techniques to precisely remove small growths, such as cancers or other tumors, from the lining of the esophagus or stomach before they grow larger and require major surgery.

Magnetic sphincter augmentation (LINX)
The LINX device is implanted around the lower esophageal sphincter to strengthen a weak sphincter to prevent acid reflux.
Revisional foregut surgery

Why Choose Providence

Conditions of the esophagus and stomach can be complex. Our team’s broad experience will help guide which medical or surgical treatments are best suited to your needs. Our team offers:

Extensive experience in the most advanced therapies
Minimally invasive procedures that dramatically improve outcomes for patients
Four advanced endoscopy locations
The most robust range of endoscopic and minimally invasive options in Oregon
Innovative approaches to esophageal disease care
A team with decades of experience that has developed and expanded many of the most complex surgical techniques in use today
Enhanced steps to optimize recovery after surgery

Tips for Managing Heartburn, Acid Reflux and GERD

Heartburn that happens 2-3 times a week could be a sign of gastroesophageal reflux disease (GERD), a serious form of acid reflux that can damage the lining of the esophagus. If you have chronic heartburn, talk to your health care provider.

This information is not intended as a substitute for professional medical care. Always follow your health care professional’s instructions.

Heartburn is the main symptom of acid reflux and GERD. It feels like a burning sensation in the center of the chest, and sometimes in the throat.

Acid reflux occurs when stomach acid backs up, or “refluxes,” into the esophagus toward the throat. It can cause symptoms such as heartburn, regurgitation, and a sour, acidic taste in the back of the throat.

GERD is a chronic condition in which acid reflux occurs at least 2-3 times a week. If untreated, GERD can cause inflammation (esophagitis) or changes in the lining of the esophagus (Barrett’s esophagus). Barrett’s esophagus may increase the risk of developing esophageal cancer.

While chronic heartburn is the most common symptom of GERD, it’s not the only one. Less common symptoms can include:

Non-burning chest pain
Difficulty swallowing (called dysphagia), or food getting stuck in the esophagus
Painful swallowing (called odynophagia)
Persistent laryngitis or hoarseness
Persistent sore throat
Chronic cough
Asthma that’s new or occurs only at night
Regurgitation of foods or fluids, or the taste of acid in the throat
Feeling as if there’s a lump in the throat
Worsening dental disease
Waking up with a choking sensation

If you have persistent acid reflux symptoms two or more times per week, despite taking over-the-counter medication, it may be time to see your primary care provider. In addition, contact your provider for advice if you have any of these symptoms:

Difficulty swallowing, or pain when swallowing
Unexplained weight loss
Blood in your vomit, or dark-colored stools
Symptoms that worsen or interfere with daily activities

Your primary care provider can help you find the right treatment based on your symptoms, and may refer you to a gastroenterologist (a specialist in digestive conditions) if appropriate.* If your condition is serious, you may need to see a surgeon.

*Some PPO insurance plans allow you to go straight to a gastroenterologist without a referral if symptoms are severe. Check with your insurance.

Two treatment approaches can offer effective relief for moderate to severe GERD symptoms:

Prescription medications: Most people gain good control of their symptoms with medications such as Nexium, Prevacid and Prilosec. Known as proton pump inhibitors (PPIs), these drugs reduce acid production by blocking the acid pumps (or proton pumps) in the stomach. More powerful than over-the-counter medicines, PPIs are the most effective medications available for controlling acid reflux.
Surgery: If PPIs cause side effects or don’t control your symptoms, surgery may be an effective option. It can help strengthen the sphincter between your stomach and your esophagus, making it a better barrier to acid reflux.

Over-the-counter medicines can help treat occasional mild (once a week or less) heartburn:

Antacids, such as Tums and Mylanta, neutralize the acid in your stomach. They work quickly, but only for a short time.
H2 blockers, such as Pepcid and Zantac, reduce acid production. They take longer to start working, but provide relief for 6-12 hours.

In addition, these lifestyle changes are known to help prevent or reduce reflux and GERD symptoms:

Maintain a healthy weight. Losing just a few pounds may reduce your symptoms.
Avoid trigger foods that promote reflux, such as caffeine, chocolate, alcohol, peppermint, fatty foods and carbonated beverages.
Avoid large meals and late-night eating, and don’t lie down after eating.
Elevate the head of your bed by 6-8 inches to reduce nighttime reflux symptoms.
Quit smoking. Smoking weakens the sphincter between the stomach and esophagus, reduces the production of acid-buffering saliva, and causes coughing, which pushes acid into the esophagus.