While heartburn is a relatively common condition, it can be long-lasting, uncomfortable, and difficult to treat with over the counter options. Frequent heartburn or acid reflux are symptoms of a potentially damaging disease called Gastroesophageal Reflux Disease (GERD).

What is GERD?

Gastroesophageal Reflux Disease (GERD) is a condition that stems from increasing or chronic heartburn and acid reflux symptoms. GERD is a painful and chronic disease which can precede esophageal cancer, so it is crucial it is treated before it progresses. Our practice offers several effective treatments for GERD. GERD can be caused by a weakened and malfunctioning Lower Esophageal Sphincter (LES), which is a muscle that closes off the esophagus from the stomach. When it is functioning normally the LES closes after swallowing, which blocks stomach acid from going up into the esophagus. When the LES malfunctions, it allows stomach acid and food back up into the esophagus causing pain and even esophageal damage. In some cases, a hiatal hernia causes acid reflux which can also lead to GERD



GERD presents itself as heartburn and acid reflux symptoms, including any of the following:
  • Continual heartburn
  • Difficulty eating and/or swallowing
  • Acid erosion on teeth
  • Chronic cough or asthma
  • Nighttime cough
  • Regurgitation
  • Chest pain
  • Treatment of Acid Reflux & GERD

    The first line, non-invasive way to treat acid reflux is to make lifestyle changes. Certain foods, drinks and even body position can make heartburn worse. Making the following changes can help reduce acid reflux symptoms:

  • Quitting smoking
  • Losing weight if your Body Mass Index (BMI) is greater than 25
  • Cutting out fatty or acidic foods
  • Eliminating alcoholic drinks
  • Avoiding bending over or lying down immediately after eating
    Another conservative approach to treating heartburn is medication. Sometimes medication effectiveness wears off or the dosage needs to be altered, so we carefully monitor the progress of our patients using heartburn medication. There are several different medications that target acid reflux including proton pump inhibitors, antacids, and prokinetics. During a consultation, Dr. Koshish will be able to discuss which medications might be an option for you.

    An established procedure for treating acid reflux is the laparoscopic Nissen Fundoplication. In this procedure, part of the stomach is wrapped around the esophagus like a collar in order to strengthen the LES. This reduces heartburn by blocking stomach acid from going up into the esophagus


    Gastric Bypass surgery is commonly known as an effective weight loss surgery, but it may also help patients find relief from acid reflux. In a gastric bypass procedure, the surgeon divides the stomach into two sections and bypasses the lower stomach and upper intestine; the reduced upper stomach is rerouted and the digestive tract shortened. Medical studies indicate that gastric bypass can alleviate GERD symptoms, in addition to promoting weight loss and offering other health benefits. Excess weight is a risk factor for the development of GERD, so patients who struggle with obesity and acid reflux may be candidates for gastric bypass. Depending on individual medical history and health goals, gastric bypass surgery may be an ideal treatment option for patients with GERD. Learn more about gastric bypass.

    Another cause of GERD is a hiatal hernia, which occurs when part of the stomach pushes through a part of the diaphragm, called the hiatus, and into the chest. This is often a very painful condition which can make acid reflux symptoms worse. Our practice fixes hiatal hernias using a minimally invasive and effective laparoscopic procedure


    If you have been diagnosed with GERD, hiatal hernia, or if you are suffering from chronic heartburn or acid reflux, schedule a consultation Dr. Koshish. He work with each patient to create a personalized plan for treating and ending heartburn.