Problems with your esophagus, the muscular tube that moves food from the mouth to the stomach, can be debilitating and often difficult to diagnose. One common issue impacting nearly 15% of people in the United States is severe gastroesophageal reflux disease, or GERD, which is when stomach acid flows back into the esophagus.
White Plains Hospital’s Esophageal Program offers a comprehensive approach to treating GERD and other conditions of the upper GI tract. It begins with advanced testing to better understand and diagnose the condition; once identified, our specialized team collaborates to offer relief through a number of surgical and non-surgical options.
Diagnosis & Treatment
The multidisciplinary approach to treatment begins with an internist making a referral to a gastroenterologist, who may perform an endoscopy – a nonsurgical procedure that uses a flexible tube with a camera and light to examine the esophagus, stomach, and the first part of the small intestine – or other specialized tests.
White Plains Hospital specializes in advanced diagnosis for esophageal conditions, and the results of the endoscopy might lead to surgery, an oncology consultation, or a non-surgical solution. An ENT (ear, nose and throat) specialist, a laryngologist, a pulmonologist, a speech therapist and a thoracic surgeon may also be involved in the diagnosis and treatment.
Common upper GI conditions treated
Gastroesophageal Reflux Disease (GERD)
GERD is a common condition which can cause symptoms such as heartburn, regurgitation and chest pains. GERD is also associated with other symptoms such as difficulty swallowing, chronic cough, and sore throat. Most people experience mild intermittent symptoms; however, when symptoms occur daily or persist despite taking antacid medications, specialized testing for GERD can help patients and their doctors better understand their symptoms. There are different procedures available to diagnose GERD, one of which is through wireless pH monitoring, also known as a Bravo test. While sedated, a patient undergoes an endoscopy where the physician attaches a very small clip to the esophageal wall. For four days, a small electronic device wirelessly transmits information about when the wearer is experiencing reflux, creating a far more accurate diagnosis than an endoscopy alone.
Once a patient is diagnosed with chronic reflux, there are several treatment options available. In some cases, medication alone may help; for others, we offer the following procedure:
GERD can be caused when acid from the stomach washes up into the esophagus due to a damaged or worn-away valve between the two. In this case, the patient can benefit from a TIF procedure. Using an endoscope, the physician recreates the barrier between the stomach and the esophagus, placing a device where the valve ought to be. This is a minimally invasive procedure and no scars are created.
Hiatal Hernia
A hiatal or paraesophageal hernia is a condition in which the stomach is pulled above the diaphragm through a widened aperture and into the chest. A small portion or the entire stomach can be involved in the hernia.
Hiatal hernias cause a variety of symptoms that range from mild to severe, including GERD (heartburn), difficulty swallowing, regurgitation of food or fluid, non-cardiac chest pain, nausea, vomiting, inability to lie flat, aspiration pneumonia, chronic cough, sinusitis, asthma, laryngitis, early satiety (feeling full quickly), fear of eating, weight loss, and iron deficiency anemia. In the most severe cases, the stomach can twist (volvulus) and become obstructed, or have its blood supply cut off (strangulation).
Treatment for symptomatic hiatal/paraesophageal hernias is surgical and involves returning the stomach to its normal anatomical position in the abdomen and repairing the aperture in the diaphragm. Surgery is performed using laparoscopic and robotic minimally invasive techniques.
Laryngopharyngeal Reflux (LPR)
Laryngopharyngeal reflux (LPR) is a condition where stomach acid and enzymes flow back up into the throat and voice box (larynx). Unlike GERD, which primarily affects the esophagus, LPR can affect the throat and vocal cords, often without causing heartburn. Common symptoms include chronic cough, hoarseness, throat clearing, post-nasal drip, and the sensation of a lump in the throat. LPR can be triggered by diet (spicy foods, caffeine, alcohol), eating habits (large or late meals), and lifestyle factors like stress or smoking. Diagnosis typically involves examining the throat and larynx, and treatment usually combines lifestyle modifications, dietary changes, and medications that reduce stomach acid production. If left untreated, LPR can lead to voice problems, chronic throat inflammation, and in rare cases, precancerous changes in throat tissue.ospital, shares expert tips on creating the ideal routine.
Esophageal motility disorders
Achalasia is a rare esophageal motility disorder where the esophagus muscles do not properly move food along. As a result, a patient may experience food regurgitation and chest pain while eating – leaving some to avoid eating, losing weight in an unhealthy manner. This situation can be addressed surgically through a per-oral endoscopic myotomy (POEM). Using an endoscope inserted through the mouth, the physician makes several cuts in the esophagus and upper stomach to allow food to pass easily. POEM patients often can go home the next day, with periodic monitoring afterward. It can also be addressed with laparoscopic and robotic techniques.
Dysphagia is a blanket medical term for difficulty swallowing solid or liquid food; it is commonly described as feeling that food is stuck in the mouth, throat or food pipe. It can be present in many diseases that affect the food pipe, impairing its function or obstructing it. An endoscopy will help determine the best course of treatment.
Esophagitis is the inflammation of the lining of the esophagus. If untreated, it can be uncomfortable and even lead to problems with swallowing. Effective treatments can include medications, lifestyle changes and, in rare cases, surgery. Our experts will advise the best path forward after a thorough examination and consultation.
Benign tumors in the stomach and small intestine, though rare, can become malignant. Early diagnosis and treatment are essential. Our specialists will discuss your options following a thorough examination and consultation.