GI Management Program
The mission of the Kelsey-Seybold Digestive Disease Program is to efficiently make an accurate diagnosis of disorders of the upper gastrointestinal tract and to control or prevent symptoms associated with the following disorders through the latest methods of treatment and self-help.
Gastroesophageal Reflux Disease (GERD) and Hiatal Hernia
Presence of GERD means material from the stomach is pushed into the lower esophagus because of a defective sphincter. The lining of the esophagus doesn't tolerate strong acid from the stomach. In hiatal hernia, a portion of the upper stomach goes up through the diaphragm and causes similar symptoms as GERD. When the stomach contents enter the lower esophagus either from GERD or hiatal hernia, heartburn and/or coughing commonly result. Rarely, pneumonia can occur if the stomach contents go high enough in the esophagus to reach the upper trachea (air passage) and lungs.
With chronic exposure of the lower esophagus to stomach acid from gastroesophageal reflux, the lining of the esophagus is replaced by tissue similar to that in the small intestines. When found in the esophagus, it's called metaplasia, a condition that increases the risk of acquiring a rare esophageal cancer called adenocarcinoma.
Narrowing or tightening of the esophagus can occur with chronic GERD, abnormal sphincter or motility of the lower esophagus, lye ingestion, hiatal hernia, previous esophageal surgery, or laser therapy. Esophageal strictures can lead to difficulty swallowing, heartburn, coughing, throwing up blood, or weight loss.
Disorders of Esophageal Motility, Achalasia, and Diffuse Esophageal Spasm
In these conditions, the smooth muscle fibers of the esophagus act in a disorderly fashion. Symptoms include difficulty swallowing, regurgitation of food, and chest pain. Two of these disorders are called diffuse esophageal spasm and "nutcracker esophagus."
Some people have recurrent heartburn without GERD or a hiatal hernia. These conditions should be verified through medical evaluation and treated with diet and antacids.