Grand Health Partners

GERD Clinic

at Grand Health Partners

What is GERD?
Causes & Complications
Treatment

“Do I really have to live with frequent heartburn, acid reflux, or GERD?


This is a common question that our providers hear. The answer is: “NO!”

GERD Clinic

At the Grand Health Partners GERD clinic, we are experts in treating reflux disease. If you’re suffering from heartburn, acid or bile reflux or GERD, schedule an appointment today to determine the best treatment
 plan for you!

Heartburn, Acid Reflux, Bile Reflux and GERD (Gastroesophageal Reflux Disease) are related conditions that involve the back flow of stomach contents including food, stomach acid and/or bile into the esophagus. Reflux can cause discomfort, irritation and long-term damage that can result in serious medical conditions or cancer.

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Basic Digestive System Anatomy

  1. Mouth: Chews/breaks down larger pieces of food
  2. Esophagus: Transports food from the mouth down to the stomach
  3. Stomach: The stomach’s main job is to hold food. It is like a balloon, getting bigger as we eat, and holds the food until our body is ready to process it. The stomach also produces acid that helps us break down food and kill bacteria.
  4. Small Intestine: A long skinny tube; the main job is absorption of nutrients
  5. Large Intestine (Colon): A wider tube shaped like a question mark; the main job is to absorb water and hold stool until we are ready to release it.

What is Heartburn, Acid and Bile Reflux?

Acid is made in the stomach to help us break down food and kill bacteria. Bile is made and released just after the stomach (in the duodenum) to help us breakdown foods, especially fats. Acid reflux occurs when stomach acid flows backward (refluxes) into the esophagus (the tube that connects the mouth to the stomach). Bile reflux is when the bile backs all the way up to the esophagus. This can happen occasionally in healthy individuals, typically after meals, and is usually temporary and is often called “heartburn”.

Common Symptoms:

  • Heartburn (a burning sensation radiating up the chest)
  • Regurgitation (food or sour liquid coming up into the throat or mouth)
  • Difficulty swallowing
  • Chronic cough or sore throat
  • A feeling of a lump in the throat


What is GERD (Gastroesophageal Reflux Disease)?

is a more severe and chronic (long term) form of acid and bile reflux. It is diagnosed when reflux occurs more than twice a week or when symptoms persist for an extended period, typically lasting for more than three months. GERD can cause more serious complications and discomfort than occasional acid reflux.

Common Symptoms:

Symptoms of GERD are similar to acid reflux but occur more frequently

  • Frequent heartburn (especially after meals or when lying down/sleeping)
  • Chronic regurgitation of food contents
  • Hoarseness or a sore throat
  • Chest pain
  • Difficulty swallowing (dysphagia)
  • Feeling of food being stuck in the throat
  • Persistent cough or wheezing
  • Erosion of tooth enamel due to stomach acid reaching the mouth
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Causes and Complications 
of Reflux/GERD

  • Certain Foods and Beverages: Spicy foods, citrus, chocolate, caffeine, and alcohol can trigger reflux and are common causes of mild reflux. Eating/drinking late at night can also contribute to reflux.
  • Obesity: Extra weight/fat cells can cause many problems, especially when it is located centrally around our abdomen. Increased weight/ obesity can increase abdominal pressure, pushing stomach contents into the esophagus, increasing frequency and severity of GERD symptoms. Click here to learn more about obesity and obesity treatments
  • Hiatal Hernia: A condition where part of the stomach pushes up through the diaphragm into the chest, which can cause acid, bile and food to reflux.
  • Weak Lower Esophageal Sphincter (LES): The LES is a muscle that acts as a valve between the esophagus and stomach. If it weakens or relaxes at the wrong times, it allows acid to flow back up into the esophagus.
  • Pregnancy: Hormonal changes and increased pressure from the growing fetus can contribute to acid reflux.
  • Smoking: Smoking can weaken the LES and increase acid production.

Complications of Untreated GERD

If left untreated, GERD can lead to more serious health problems, including:

  • Esophagitis: Irritation/Inflammation of the esophagus that can lead to pain, food feeling stuck or difficulty swallowing; scarring, long term damage like Barrett’s or Cancer.
  • Strictures: Narrowing of the esophagus due to scarring, which can make swallowing difficult.
  • Barrett’s Esophagus: A condition where the lining of the esophagus changes, increasing the risk of esophageal cancer.
  • Respiratory Issues: GERD can cause asthma-like symptoms or pneumonia if contents back all the way up and then enter the lungs.
  • Cancer: Long Term reflux can cause esophageal cancer

Treatment Options

Treatment for Heartburn, Acid Reflux, Bile reflux and GERD typically involves a combination of lifestyle changes, medications, and in some cases, surgery. Lifestyle modifications may include avoiding trigger foods, losing weight, and eating smaller meals. Medications may include antacids, proton pump inhibitors (PPIs), or H2 blockers. Surgical options include fixing hiatal hernias, wrapping the stomach around itself (fundoplication) and surgery to help treat obesity.

The treatment options for GERD (Gastroesophageal Reflux Disease) and Reflux typically involve a combination of lifestyle changes, medications, and in some cases, surgical interventions. The goal is to relieve symptoms, improve quality of life, and prevent complications. Here’s a breakdown of heartburn treatment options offered at Grand Health Partners in Grand Rapids.

Lifestyle Modifications

  • Dietary Changes:
    • Avoid trigger foods that can worsen reflux, such as spicy foods, citrus, chocolate, caffeine, alcohol, and fatty or fried foods.
    • Eat smaller, more frequent meals to avoid overloading the stomach.
    • Avoid lying down immediately after eating; try to wait at least 2–3 hours.
    • Lose weight if you’re overweight or obese to reduce pressure on the stomach.
    • Elevate the head of your bed to prevent acid from traveling up the esophagus while sleeping.
  • Quit Smoking: Smoking weakens the lower esophageal sphincter (LES), which increases the risk of acid reflux.
  • Reduce Alcohol Consumption: Alcohol can relax the LES and increase acid production, worsening symptoms.

Schedule a Consultation with our Anti-Reflux Specialists now!

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Medications

Several types of medications can help manage GERD symptoms:

Antacids

These neutralize stomach acid and provide quick relief for mild, occasional acid reflux. Examples include Tums, Maalox, and Rolaids.

Pros: Fast-acting.

Cons: 

  • Only provides short-term relief (usually a few hours)
  • Often cause “rebound” heartburn/reflux when the medication wears off
  • Does not address the underlying cause

H2 Receptor Antagonists (H2 Blockers)

These drugs reduce the amount of acid the stomach produces. Examples include ranitidine (Zantac) and famotidine (Pepcid).

  • Pros: Provide longer-lasting relief than antacids (usually 12 hours).
  • Cons: Can be less effective for severe GERD compared to PPIs

Proton Pump Inhibitors (PPIs)

PPIs reduce stomach acid production more effectively and are often prescribed for more severe cases of GERD. Examples include omeprazole (Prilosec), lansoprazole (Prevacid), and esomeprazole (Nexium).

  • Pros: Highly effective for reducing acid production and healing the esophagus and healing the stomach. Effects usually last 24 hours.
  • Cons: Long-term use can have side effects, such as nutrient deficiencies (e.g., magnesium, vitamin B12) and an increased risk of certain infections, increased risk of Alzheimers.

Prokinetics

These medications help improve the movement of food and acid through the digestive tract, reducing reflux. Examples include metoclopramide (Reglan).

  • Pros: Can help with delayed stomach emptying.
  • Cons: More frequently it has side effects (fatigue, dizziness, and anxiety) and can’t be taken long term.

Bile Acid Sequestration

These medications help bind bile. Example: Cholestyramine (Questran)

  • Pros:  Helps with Bile Reflux
  • Cons: Can be bothersome to take and has frequent side effects

Other Antacids

 These medications form a barrier that floats on top of the stomach contents to prevent reflux. An example is Gaviscon, Carafate.

  • Pros: Provides a protective barrier against acid.
  • Cons: Can be bothersome to take frequently.

Surgical Treatment

Surgical Procedures often times have significant reduction of GERD symptoms and reduce long term risks of damage to the esophagus and cancer. Often, patients can get off of long term use of PPIs and avoid the long term negatives of being on that medication for years. 

Surgery is considered

  • When lifestyle changes and medications are not sufficient to control GERD symptoms
  • Severe esophagitis (damage/irritation to the esophagus)
  • Barrett’s esophagus (long term damage to the esophagus, causing the cells to change)
  • Difficulty swallowing.
  • Inability to tolerate medications or desire to avoid long term negative side effects of medications such as PPIs

Learn More about Obesity on GHP’s Main Website

Surgical options include:

Hiatal Hernia Repair

Many patients with frequent of severe Reflux have a Hiatal Hernia. This is a condition where your stomach pushes up through the diaphragm and into the chest cavity. This often causes reflux symptoms and feelings of food getting stuck.

Surgical repair of a hiatal hernia brings the stomach back down into the abdominal cavity and tightens the muscles of the diaphragm around the esophagus

Hiatal Hernia Repairs can be performed alone and can be performed with a fundoplication or a bariatric (weight loss) operation

Fundoplication

This is a very common surgical treatment for GERD. It involves wrapping the top of the stomach (Fundus) around the lower esophagus to strengthen the LES and prevent reflux.

  • Pros: Can provide long-term relief from GERD symptoms.
  • Cons: Can make it difficult or impossible to vomit, lead to difficulty swallowing or lead to gas bloating of the stomach.
Obesity (Weight Loss) Surgery

Surgery that helps reduce weight, and more importantly fat cells, to help you be healthier in many ways

Losing weight and getting healthier often can help reduce or eliminate GERD symptoms, especially when combined with a hiatal hernia repair, as mentioned above.

  • Pros: Can provide long-term relief from GERD symptoms and help treat many other major health problems like diabetes, heart disease, high blood pressure, high cholesterol, sleep apnea and many others.
  • Cons: requires commitment to lifetime changes of diet/exercise

Endoscopic Procedures

For some patients, minimally invasive endoscopic procedures can help reduce GERD symptoms without surgery:

  • Endoscopic Fundoplication: A procedure where the LES is tightened using an endoscope (a thin, flexible tube).
  • Stretta Procedure: Uses radiofrequency energy to improve the function of the LES by stimulating tissue growth, making it tighter.
  • Pros: Less invasive than surgery, with a faster recovery time.
  • Cons: May not be as effective for everyone and may not be covered by insurance.

Surgery does entail an amount of risk including but not limited to: infection, bleeding, incomplete effects on GERD symptoms or symptom/hernia recurrence, damage to other areas/organs, anesthesia complications, and death.

Complementary and Alternative Therapies

  • Herbal Remedies: Some people find relief using herbal remedies such as slippery elm, chamomile, or licorice root. However, it’s important to consult with a healthcare provider before using these, as they can interact with medications or have side effects.
  • Acupuncture: Some studies suggest acupuncture may help reduce GERD symptoms in certain people.

Monitoring and Follow-up Care

For those with chronic GERD, ongoing management is important. Regular check-ups with a healthcare provider can help monitor the condition, evaluate for complications (like Barrett’s esophagus), and adjust treatment plans as necessary.

When to Seek Medical Help

If you experience any of the following symptoms, it’s important to seek medical attention:

  • Severe chest pain or difficulty swallowing.
  • Unexplained weight loss.
  • Persistent or worsening symptoms despite treatment.
  • Difficulty breathing, especially at night.
  • Hoarseness or a chronic sore throat.

Combination Therapy: Many patients benefit from combining medication and lifestyle changes for more effective management.

What Happens When You Make an Appointment 
with the GHP GERD Clinic?

We will set up an initial consultation with a provider
  • Review your medical history
  • Discuss your symptoms of Reflux/GERD
  • Review what testing has been done already
  • Develop an action plan
    • Does further testing need to be done?
    • Are there medication adjustments that can be make?
    • Would you benefit from a surgical consultation?

Common Testing Options (If Applicable)
  • EGD: A camera to take a look down your mouth, esophagus, stomach and part or the small intestine – one of the first and best tests to assess Reflux/GERD
  • UGI: X-ray study that watches what happens when you drink something
  • pH study: tests the acid level in your esophagus throughout the day
  • Manometry: tests how your esophagus is functioning

Surgical Consultation (if applicable)
  • Review the testing and discuss the symptoms with a GHP Surgeon
  • Discuss options for surgical and non-surgical care or GERD (See Above for more details on the options)
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Schedule a Consultation with our Anti-Reflux Specialists now!

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