Most people have experienced heartburn after a spicy meal or a late-night snack. But when heartburn, regurgitation, chronic cough, hoarseness or trouble swallowing become part of daily life, it may be more than an inconvenience. It may be gastroesophageal reflux disease, or GERD.
GERD happens when the valve between the esophagus and stomach does not work the way it should. Instead of keeping stomach contents where they belong, that valve allows acid and other stomach fluid to flow back into the esophagus. That backflow can cause the burning feeling many people know as heartburn, but reflux can show up in other ways too. Some patients come to me after months of coughing, voice changes, or chest discomfort that has disrupted sleep, meals, and everyday routines.
Reflux also deserves attention because ongoing, poorly controlled acid exposure can damage the lining of the esophagus. In some people, that damage can lead to Barrett’s esophagus, a condition in which the normal lining changes into intestinal-like cells as a way of protecting itself from acid. Barrett’s esophagus is important because it can increase the risk of esophageal cancer.
Medications such as omeprazole or pantoprazole can be helpful. They reduce stomach acid and often make symptoms more manageable. But they do not stop reflux from happening. If reflux is caused by a mechanical problem, medication may make the backflow less acidic, but it does not repair the valve or correct a hiatal hernia.
That is why careful evaluation matters. In our foregut surgery program at Intermountain Health Lutheran Hospital, we use specialized testing to understand how the esophagus, stomach and reflux valve are working. The goal is not to offer one standard answer to every patient. The goal is to match the right treatment to the right person.
For some patients, lifestyle changes and medication are enough. Others may benefit from procedures that address the underlying cause of reflux. Fundoplication, a surgery that strengthens the reflux barrier by wrapping part of the stomach around the lower esophagus, has helped patients for decades. Some patients may qualify for incision-free procedures performed through a scope. Another option is a procedure that uses a small ring of magnetic titanium beads to help recreate the body’s natural reflux barrier while still allowing normal swallowing.
Surgery is not the right choice for everyone, and it is normal for patients to feel nervous when they hear the word “surgery.” My job is to help people understand their options, answer questions clearly, and recommend treatment only after we understand what is happening anatomically and functionally. We also follow patients after surgery and measure outcomes, so we know whether the repair is working as intended.
If you have frequent heartburn, regurgitation, chronic cough, hoarseness, unexplained chest discomfort or difficulty swallowing, please talk with your healthcare provider. Reflux is common, but that does not mean you have to simply live with it. With the right evaluation, many people can find lasting relief and return to eating, sleeping and living more comfortably.
Emily Speer, MD, is a surgeon with Intermountain Health who specializes in foregut and minimally invasive surgery. She serves as medical director of reflux surgery at Intermountain Health Lutheran Hospital, where she leads a specialized program focused on comprehensive evaluation and personalized treatment for reflux and related conditions.
