Gastroesophageal Reflux Disease (GERD)

What Is Gastroesophageal Reflux Disease (GERD)?

GERD (acid reflux disease) occurs when the acid from the stomach flows up into the esophagus. The acid in the stomach is a strong chemical that helps digesting your food. While the stomach is designed to handle its own acid, the linning of the esophagus will be severly burned by the repititive exposure to this acid. This exposure may cause symptoms that vary in severity depending on the damage. To some extent, every normal person has acid reflux. Normal non pathologic reflux happens after meals. This reflux is usually brief and without symptoms, and rarely occurs during sleep.

The diagnosis of abnormal reflux is easy when heartburn or other related GERD symptoms occur frequently.

Causes of GERD:

There is a valve that is located at the connection of the esophagus and the stomach. This valve is a one way valve that is called the lower esophageal sphincter (LES). The value of this valve is to allow food to pass to the stomach while prevents the acid from flowing up to the esophagus.

Any damage or weakness to the this valve located at the bottom of the esophagus (LES) will cause GERD symptoms. Other causes include:

Hiatal hernias

Fatty meals

Increase pressure on the stomach, such as pregnancy and being overweight.



Alcohol consumption


  • Obesity
  • Hiatal hernia
  • Dry mouth
  • Asthma and chronic cough
  • Diabetes
  • Delayed stomach emptying
  • Connective tissue disorders, such as scleroderma
  • Zollinger-Ellison syndrome

A hiatal hernia is the bulging of the upper part of the stomach into the posterior chest through an enlarged hiatal opening.

What Are the Symptoms of GERD?

The most common symptom is heartburn, a burning feeling in the middle of the chest. It sometimes spreads to the throat. An acid taste may occur. Heartburn affects about 10 million adults in the United States daily. Other symptoms include chronic cough, hoarseness, upset stomach, stomach bloating, and wheezing. More serious symptoms are bleeding, weight loss, and diffi culty swallowing.

How Is GERD Diagnosed?

The doctor relies on symptoms and the response to treatment for diagnosis. Life-threatening diseases, such as heart disease, that can cause symptoms similar to those of GERD must be ruled out. Specifi c tests are needed for an unclear diagnosis or more serious symptoms. These tests may include upper GI (gastrointestinal) x-ray series, endoscopy (using a scope to look at your esophagus and stomach directly), 24-hour esophageal pH study (measurement of acidity), and esophageal manometry (measures esophageal muscle pressure).

How Is GERD Treated?

First options for mild refl ux include eating smaller portions and changing the diet. Certain foods, such as tomatoes and fatty foods, and medicines, such as aspirin, can make symptoms worse. Over-the-counter drugs, including antacids and acidblocking medicines called H2-blockers, may help. Antacids neutralize stomach acid. H2-blockers (e.g., ranitidine or famotidine) prevent or block production of stomach acid. These drugs can be taken before eating to prevent heartburn. Omeprazole is another over-the-counter drug now available, which blocks the action of stomach cells responsible for making acid. It is generally more effective than antacids and H2-blockers.

People with severe or frequent symptoms may need prescription drugs. In resistant cases, your doctor may refer you to a surgeon to perform an operation called fundoplication to strengthen the LES.

How to choose a surgeon?

How to choose a surgeon?

So, you were told that you need surgery?

A decision to have surgery (major or minor) is definitely not an easy one to make. It is an important healthcare decisions.which involves the patient as well as the family. This decision should be taken seriously.

Most probably your referring physician or primary doctor have recommended a surgeon. They may actually went as far as referring you to one. The good thing about their referral is they have worked or known that surgeon for a period of time. That does not mean that you should go and have the surgery without some homework. Don’t take your surgeon’s qualifications for granted.

Finding the right surgeon can be a challanging task.

Here are some tips and information that will help you make this important decision.

1- Know you Disease

Before you start, you need to know your disease. At least the name of the disease. I cannot even tell you how many patients showed to my office without knowing the reason. The health care information is readily available on the internet and the public library. Search and learn. Read and study. It is your health.

I am not asking you to become a doctor or a physician. but I am asking you to be a responsible patient (custmor). In a different language, you are shopping for the most important decision that may involve your life. For an example, we take time to study the different brands, sizes, colors and prices before we buy a refrigerator. Our health and lives diserve the same attention to details, the very fine details.

Knowing your disease will help you:

  • Understand the magnitude of the problem.
  • Ask your surgeon the appropriate questions.
  • Establish a good rapport with the surgeon.
  • Gain the surgeon’s respect.

2- What to look in a Surgeon

  • Education and Training
  • Speciality Board certification
  • The American College of Surgeons Fellowship
  • Outcome Data
  • Community and Patients Recommendation
  • Surgical Volume for that particular operation.
  • Hospital Affiliation

Selim on KCTV news

New technology makes operations less painful, more successful

Posted: Feb 14, 2012 7:05 AM CST
Updated: Feb 28, 2012 7:05 AM CST
By Chris Oberholtz, Multimedia Producer – email
By Nima Shaffe, News Reporter – email



Dr. Niazy Selim is a surgeon at KU Med, and he removed the mayor’s gallbladder.




The University of Kansas Hospital is the only hospital in a seven-state area to perform a new minimally invasive surgery.

When people think of da Vinci, they probably think of the famous artist from history. However, at KU Med, da Vinci is a robot performing minimally invasive surgeries like gallbladder removal.

The procedure was approved by the FDA in December.

And one of the robots first patients is a familiar face right in Kansas City.

Kansas City, KS, Mayor Joe Reardon conducts city business, but recently he had to take care of some business of his own.

“First of all, I had heard from other folks about Dr. Selim, so the reputation of a great surgeon that is here at KU which we are coming to expect at this medical center, you know you have got quality people working here day in and day out,” Reardon said.

Reardon was the first patient to have the operation done in the metro.

“Couldn’t think of a better place to be when I needed to have my gall bladder addressed than right here,” Reardon said.

Reardon’s gallbladder was removed by the robot.

Dr. Niazy Selim is a surgeon at KU Med, and he also helped removed the mayor’s gallbladder.

Selim said the benefits of the new da Vinci robot are countless.

“Minimally invasive, very small scars, less post-operative pain, earlier recovery for the patient and earlier return to work,” Dr. Niazy Selim said.

Aside from being sore, Reardon says the pain feels like he has been working out the abdomen area.

“That is the kind of soreness,” Reardon said.

Selim said what makes the da Vinci different than most other robots out there is that it translates every movement that the hand does

“When you pull, it will move the arms … you push, it takes in … you turn, your hands, it turns in,” Reardon said.

In less than a week after having the procedure the Reardon said it was just a matter of adjusting to being without the gallbladder.

“Going forward is going to be something that is a lot better than when I was or I had it before,” Reardon said.

Reardon also said his mom has been around to help him and take care of him since his surgery.

Selim said the technology was originally engineered by NASA more than 20 years ago. However, the gallbladder removal procedure was approved by the FDA back in December.

Copyright 2012 KCTV (Meredith Corp.) All rights reserved.