The Heartburn Treatment Center offers a comprehensive program designed to treat GERD and digestive problems. The focus of the center is on assisting patients through dietary, lifestyle changes, medical management and/or minimally invasive surgical management.
A heartburn nurse coordinator will assist your referring physician with assessment and selection of appropriate treatment based on your individual needs. Many heartburn sufferers find help through lifestyle changes and medications. However, some do not, and the nurse coordinator will work with you to select the treatment option that best meets your needs.
At the center, we use the latest diagnostic and treatment options available such as:
- Esophageal Motility Studies
- Bravo 48 hour (wireless) pH Studies
- Standard 24 hour pH Studies
- Pill Cam Studies-Esophageal and Small Bowel
High Resolution Esophageal Motility (Manometry) Study
The esophageal motility or manometry study allows for the measurement of pressures and muscle contractions in the esophagus. Abnormalities that arise from abnormal motility studies can cause patients to have heartburn, chest pain, difficulty swallowing, esophageal reflux along with vomiting or nausea. The test takes approximately 15-30 minutes to complete and causes minimal discomfort. The healthcare provider first will numb one nostril using a topical numbing agent. Once numb a flexible catheter (about the size of a spaghetti noodle) is placed to the numb nostril and advanced into the stomach with swallows of water. Once in place, the patient is placed in a semi-reclined position and given swallows of water. After completion of the swallows, the catheter is removed and the patient is discharged home. The majority of patients tolerate this study very well, with little or no discomfort.
Bravo Wireless 48 hour pH study
This procedure is done to assess for acid in the esophagus for patients who experience such symptoms as heartburn, indigestion, chest pain, cough or hoarseness and more. It is done by placing a capsule or probe, about the size of a pencil eraser, into the esophagus using a flexible guide wire. Once in the correct location, gentle suction is used to draw a small bump of esophageal tissue into the probe for 30 seconds. The probe is then attached to the esophagus by placing a small stitch into this bump of tissue. The probe is disconnected from this guide wire and the guide wire is then removed. The patient wears a small box on their hip that records acid data for 48 hours, and the patient maintains a diary for when they eat and lie down. They are asked to live their daily lives normally. Once the study is completed, the patient returns the data recorder back to the facility where it is downloaded and the report is then given the referring physician. The probe typically falls off of the esophagus within 3-7 days and passes naturally through the patients' digestive tract without causing any damage. The procedure maybe done with the patient awake or asleep and usually takes no longer than 1 minute to complete.
24 hour Trans-nasal pH study
This test like the Bravo study allows for evaluation of the patients symptoms that may be linked to GERD. The 24 hour pH study is a procedure in which a small narrow catheter is placed through the patient's nostril to a predetermined depth while the patient takes sips of water. Once in place, the catheter is secured to the face and neck with tape then attached to a data recorder that is worn for 24 hours. They live life normally and keep a diary for when they eat, drink, recline and sleep. 24 hours after the study is started, they return for removal of the catheter. The recorder is then downloaded and the information is interpreted by their physician who makes decisions on further treatment.
Capsule Endoscopy (Pill Cam)
The Pill Cam procedure assesses patients' small intestine to evaluate for different problems that may affect this part of the GI tract. These include sources of gastrointestinal bleeding, anemia, small bowel obstruction, etc. The test lasts 8 hours. The patient ingests a small capsule the size a multi-vitamin which has a camera in it. This camera takes multiple pictures every second and these are stored on a data recorder. The recorder collects the images wirelessly with the patient only wearing a sensor belt or small stickers on the torso. After ingestion, the patient is encouraged to only have sips of water for 4 hours followed by a light diet (soup or sandwich) and then may be advanced to a regular diet as they day goes along. After the 8 hours, they return to the department for removal of the data recorder and sensor belt or leads. The data recorder is downloaded and the information is sent to their physician who interprets the data for possible diagnosis and decision for treatment. The capsule will pass through the patient's digestive tract and is usually passed in the stool around 1-3 days post study. The passed capsule may not be seen by the patient.
Agile Patency Capsule
This procedure may be done prior to a Pill Cam to assess the ability of the capsule from the Pill Cam to passes appropriately through the small bowel. Physicians with patients who are suspected of having a small bowel obstruction, difficulties with Crohn's disease or concerns that the capsule may get lodged during capsule study, may order this procedure. The procedure is done the same way a Pill Cam is done with the patient having a clear liquid diet the day prior to the study followed by a night of fasting. They come into the center and ingest a capsule the same size as the Pill Cam capsule. They are encouraged to have sips of water for 4 hours after ingesting, and then may return to a light meal diet (soup/sandwich). The next day, they are required to have an X-ray of their abdomen to assess the location of the Agile capsule. Their physician will review the X-ray and decide whether or not to proceed with the Pill Cam portion of the study. The Agile capsule contains an RF (radiofrequency) piece that will illuminate its location on x-ray. The capsule portion will dissolve over time and will not cause any problems.