Image for GERD article Heartburn. Acid reflux disease. GERD. More than 60 million American adults experience symptoms of GERD at some point in their lives, and at least 25 million of them experience these symptoms daily. Treatment options for those with GERD can range from dietary changes to medications and surgery, but their effectiveness has not always been satisfactory. An implant approved by the FDA offers another option for those suffering from GERD.

Gastroesophageal reflux disease (GERD) occurs when the lower esophageal sphincter (LES) does not close properly. The LES is a ring of muscle that surrounds the connection between the esophagus and the stomach. Normally, it operates much like a valve, preventing the contents of the stomach from refluxing (leaking back) into the esophagus. When the LES fails to function normally, stomach acid may reflux back into the esophagus and cause a burning sensation in the chest or throat. This burning sensation is commonly known as heartburn.

Symptoms of GERD

The primary symptom of GERD is heartburn. Heartburn symptoms usually occur after overeating or lying down after a big meal. They may last for a few minutes or a few hours. The severity of symptoms depends on the reason the LES does not close, the amount of acid entering the esophagus, how much the saliva is available to neutralize it, and any residual esophagitis (inflammation of the esophagus) from previous bouts of reflux.

Symptoms include:

  • Burning feeling that starts in the lower chest and may move up the throat
  • Feeling that food is coming back up
  • Sour or bitter taste in the throat
  • Pain that increases when bending over, lying down, exercising, or lifting heavy objects
  • Sore throat
  • Cough
  • Feeling of a lump in the throat
  • Asthma
  • Laryngitis (hoarse voice)
  • Aspiration pneumonia
  • Pulmonary fibrosis (scarring of the lungs)

Consequences of GERD

If GERD is left untreated, the consequences may be serious. Stomach acid is extremely strong and can eventually damage the esophagus. In some cases, it may even lead to a pre-cancerous condition called Barrett’s esophagus. Symptoms of esophageal damage include:

  • Esophagitis
  • Bleeding and ulcers in the esophagus
  • Difficulty swallowing
  • Vomiting blood
  • Black or tarry stools
  • Strictures (scarring and narrowing of the esophagus)
  • Barrett's esophagus (condition of the esophagus, which can lead to esophageal cancer )
  • Dental problems (due to the effect of the stomach acid on the tooth's enamel)

Treatment of GERD

In general, treatment of GERD is designed to decrease the number of episodes of heartburn and reduce its complications. Therapies focus on decreasing the production of stomach acid and reducing or stopping the flow of acid back into the esophagus. Treatments for GERD may include medications, lifestyle changes, or surgery.

Enteryx

The FDA approved an implant that may help people with GERD who wish to avoid surgery. Enteryx is a permanently implanted device made up of polymer and a solvent that is implanted by injection into the lower wall of the esophagus during an x-ray guided endoscopic procedure. It is most effective in patients with GERD who currently require treatment with proton pump inhibitors, a particular type of medication commonly used in the treatment of GERD.

After Enteryx is injected, the solvent separates away and the polymer solidifies into a spongy material that reinforces the LES and keeps stomach acid from refluxing into the esophagus. The long-term effects of the implant are unknown.

The most common side effects seen in patients who had received the Enteryx device was pain beneath the breastbone. This usually subsided within two weeks. Other common side effects included temporary difficulty swallowing, fever, sore throat, and gas, bloating, or belching.

Unfortunately, like many of the other treatment options for GERD, the implant is not 100% effective. In one 12-month study, approximately 67% of the participants were able to discontinue all of their medications, 9% were able to reduce their current dosage by half, and 72% noted at least some improvement in their symptoms.

If you currently suffer from GERD, speak with your doctor to see whether Enteryx may be a treatment option for you. According to the FDA, Enteryx should not be used in people who are unable to undergo endoscopy or who have dilated veins in their esophagus as a result of liver disease.