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Conditions & Treatments

Esophageal & Motility Disorders

Esophageal and stomach conditions can range from acid reflux in the form of mild heartburn that is easily treated with lifestyle changes and medication, to disorders that can become serious and life-threatening.

At Einstein, we are experts in the latest tests and treatment options for a full range of these conditions, including radio-frequency ablation for Barrett’s esophagus and other advanced endoscopic procedures.

Our gastroenterologists are some of the most experienced in the region at treating Barrett’s esophagus with radiofrequency ablation therapy, which uses heat to destroy scar tissue, widening the esophagus and relieving symptoms.

We provide personalized treatment plans for acid reflux and gastroesophageal reflux disease, including an advanced, minimally invasive procedure called transoral incisionless fundoplication that prevents the contents of the stomach from flowing back into the esophagus, relieving heartburn and acid indigestion.

Also known as dysphagia, difficulty swallowing can have a number of different causes, including GERD, weakening or scarring of esophageal muscles, tumors and neurological conditions. Depending on the cause of your dysphasia, it may be treated with lifestyle changes, medications, therapies or surgery.

Gastrointestinal bleeding can be a serious condition caused ulcers, sores, inflammation or tears in the lining of the gastrointestinal tract. In some cases, you may notice blood in your stool or vomit, but in others the bleeding may be less obvious. Other symptoms include abdominal or chest pain, lightheadedness and difficulty breathing, and treatments may include medication, lifestyle changes and procedures such as endoscopy or colonoscopy.

When stomach acid or irritants damage tissue in the esophagus over time, it can cause the formation of scar tissue and a narrowing or tightening of the esophagus. This can make it difficult to swallow, increase the risk of choking, and even lead to complete obstruction of the esophagus, preventing food and fluids from reaching the stomach. Treatments include medication and lifestyle changes, esophageal dilation and stent placement to widen the esophagus and prevent it from narrowing.

When contractions in the esophagus that push food toward the stomach become irregular, unsynchronized or absent, it can cause a variety of problems known as esophageal motility disorders. Symptoms may include difficulty swallowing, heartburn and regurgitation. Treatments may include medication and lifestyle changes as well as endoscopic and other procedures.

Peptic ulcers occur when your stomach acid damages the walls of your stomach or small intestine, causing an open sore and gastrointestinal bleeding. The main symptoms are discomfort or burning pain, especially on an empty stomach. Other symptoms may include lack of appetite, a bloated feeling, nausea, vomiting and blood in your stool. Long-term use of pain relievers such as aspirin, ibuprofen and naproxen can increase your risk for peptic ulcers, and stress and spicy foods can irritate them and make them harder to treat. In most cases, they can be treated with lifestyle adjustments and medication.

When your stomach does not empty the way it should, it can cause bacteria to grow and create obstructions that cause a variety of health problems. Gastroparesis is a chronic condition that may require a variety of tests to diagnose, and is usually managed with medication.


Diagnostic Testing & Treatment

The digestive health team at Einstein offers a full range of the most advanced diagnostic testing and treatment for esophageal and stomach conditions.

The most common procedure used in diagnosing esophageal and stomach conditions, endoscopy is a nonsurgical procedure that helps your gastroenterologist examine your esophagus, stomach and upper small intestine using a flexible tube with a camera attached. During an endoscopy, your doctor may take biopsies to check for infections, certain diseases and rule out cancer. If there is evidence of abnormalities that require treatment, such as bleeding or stretching of the esophagus for a narrowing, it will be performed. Your endoscopy will be performed under sedation, and you will need to fast for six to eight hours prior to the procedure.

In some cases, your gastroenterologist may use a special endoscope that creates an ultrasound image of your upper gastrointestinal tract, aiding in the detection of conditions that may be hard to see with the endoscopic camera.

If a narrowing is found in the esophagus, your gastroenterologist may decide to treat the blockage. A balloon or a bougie dilator may be used to open up the narrowing. In rare cases, an endoluminal stent may be placed to prevent the area from closing again.

This procedure treats precancerous tissue in the esophagus using high-frequency heat energy, and is an effective treatment for Barrett’s esophagus.

HRIM is used to diagnose problems with the coordination and function of the esophagus. During the procedure, a thin, flexible tube that contains pressure sensors is passed through your nose, down your esophagus and into your stomach. You are then given swallows of liquid and jelly-like substance. The pressure generated by the esophagus is transferred to the sensors and then uploaded to a computer for analysis.

To diagnose GERD, better understand your condition and develop a personalized treatment plan, your doctor may perform one of two reflux monitoring tests. For the 24-hour pH/impedance test, a thin flexible tube is passed through your nose and into your stomach, and measures the amount of acidic and non-acidic reflux over a 24-hour period. For the Bravo™ pH test, a small capsule is temporarily attached to the wall of your esophagus during an endoscopy, and transmits readings to a receiver you wear on your belt.

You will be able to eat, drink and do most things normally during both tests, and asked to keep a diary of your food, drink, medications and activities. You may also be instructed to stop taking acid-reducing medications prior to the tests, and will receive further instructions from your doctor.

Small intestinal bacterial overgrowth (SIBO), a condition in which bacteria that normally live in your large intestine end up in your small intestine. This can cause symptoms of bloating, abdominal pain, diarrhea, and weight loss. In this test, you ingest a manmade sugar that can only be digested by these bacteria and collecting breath samples over a three-hour window. A lab analysis of the samples will determine if you have SIBO and where the bacteria is located, helping your doctor develop a treatment plan.

Frequently Asked Questions

Acid reflux is a common condition that happens when stomach acid or bile flows upward from the stomach into the esophagus (the pipe connecting the mouth and stomach) and irritates the lining of the esophagus.

Common triggers for acid reflux include:

  • Citrus fruits
  • Tomatoes
  • Onions
  • Chocolate
  • Coffee
  • Fried or fatty foods
  • Aspirin or ibuprofen
  • Sedatives
  • Blood pressure medication
  • Tobacco

You may be able to relieve the symptoms of acid reflux by making a few lifestyle changes. If acid reflux symptoms persist, consult with a gastroenterologist.

  • Eat smaller meals
  • Don’t lie down after meals
  • Avoid acidic or fatty foods, alcohol, and carbonated beverages
  • Drink more water
  • Quit smoking
  • Determine if the medications you’re currently taking cause acid reflux

Gastroesophageal reflux disease (GERD) is a chronic condition resulting from the backflow of stomach acid (with or without bile) into the esophagus. GERD is also known as acid reflux. Gastroesophageal reflux disease (GERD) cannot be cured, but it can be managed through changes in diet, lifestyle, and medication. In some cases, surgery can be performed to prevent further transit of acid from the stomach to the esophagus

You can treat GERD on your own with diet and lifestyle changes. However, a gastroenterologist will help to rule out other conditions, identify possible causes, and suggest additional GERD treatments.


Request an Appointment

So when should you schedule an appointment?

If you are unsure when you should meet with a doctor and you are experiencing chronic or recurring abdominal pain, diarrhea, constipation, incontinence, gastrointestinal bleeding or other symptoms of a gastrointestinal condition, make an appointment with one of our specialists today.

Request an Appointment

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