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Conditions We Treat
The Heartburn Center offers a multidisciplinary approach to diagnosing and treating gastroesophageal reflux disease (GERD) and related disorders. We are a leader in state-of-the-art therapies for the following:
To make an appointment for the following conditions, please call: (410) 933-7495.
- Gastroesophageal reflux disease (GERD) — GERD occurs when the gastric contents of the stomach move up into the esophagus, causing heartburn, regurgitation, chest and back pain, difficulty swallowing and other symptoms related to the throat, larynx or lungs. Symptoms are often frequent or severe and lead to injury. We treat GERD that is considered refractory, meaning it is unresponsive or not fully responsive to proton pump inhibitor (PPI) drugs. We also treat patients who are PPI-responsive but averse, meaning PPI drugs are effective, but the patient doesn’t want to continue taking them for various reasons.
- Laryngopharyngeal reflux disease (LPRD) — LPRD is a manifestation of GERD that causes acid reflux. Patients may have a dominant symptom that isn’t typical, including throat soreness, the sensation of mucus or phlegm at the back of the throat, chronic cough, asthma-like symptoms and even waking at night due to choking.
- Barrett’s esophagus — Barrett’s esophagus is a complication of GERD that causes erosions in the esophagus and can lead to esophageal cancer. Endoscopic therapies such as resection or ablation (radiofrequency ablation, cryoablation) are highly successful minimally invasive non-surgical treatments that can eradicate Barrett’s esophagus and prevent cancer. Our endoscopists are expert in this area.
- Hiatal hernia — People with hiatal hernias are predisposed to - reflux because the top of the stomach can prolapse into the chest, bathing the esophagus with stomach acid. We offer both endoscopic and surgical treatments for these types of hernias. GERD may often be due to slippage of the top of the stomach into the chest. Small hernias that are less than an inch may be repaired endoscopically with a procedure called transoral incisionless fundoplication or TIF. Johns Hopkins specializes in this minimally invasive treatment. Larger hernias need to be repaired using minimally invasive surgical approaches. Our surgeons specialize in laparoscopic and robotic treatments for GERD.
- Dysphagia — Dysphagia is difficulty with swallowing, which may be due to reflux-related strictures (narrowing of the esophagus, possibly from scar tissue). Another cause, which leads to symptoms similar to those of GERD, is the allergic inflammatory condition eosinophilic esophagitis. We work closely with our specialists in Allergy and Immunology to develop a comprehensive treatment plan. Another cause of chronic GERD-like symptoms and trouble swallowing is a condition called achalasia, which is due to decreased esophageal motility and a spastic sphincter at the end of the esophagus. Endoscopic therapy such as peroral endoscopic myotomy or POEM may be recommended for achalasia.
- Zenker's (Pharyngoesophageal) Diverticulum — This is a sac just above the upper entrance into the esophagus, which can cause trouble with swallowing, throat pain, and reflux-type symptoms. This condition has typically be treated with an operation. Our endoscopic specialists can also treat this condition with minimally-invasive outpatient endoscopic approaches.
To make an appointment for the following conditions, please call: (443) 997-1508.
- Paraesophageal hernia — These types of hernias occur when a larger part of the stomach slips into the chest through an opening in the diaphragm. These often need surgical treatment.
- Failed Nissen fundoplication — For people who undergo a Nissen fundoplication procedure for hernia or reflux, there’s a failure rate of up to 20 percent. Repeat operations are typically more difficult and less successful. We recommend endoscopic transoral incisionless fundoplication (TIF) for these patients if the Nissen wrap fails without a hernia recurrence. Johns Hopkins is the only institution in Maryland that offers this procedure.
- Esophageal diverticulum — Patients with this rare disorder experience outpouching of the esophagus that traps material and can cause inflammation, regurgitation, dysphagia and aspiration pneumonia. Surgical treatment is often recommended.