GERD Awareness Week

This week is national Gastroesophageal Reflux Disease (GERD) Awareness Week. Studies show that one in three people suffer from GERD, a condition in which the contents of the stomach leak backward from the stomach into the esophagus, or food pipe, causing irritation.

Over time, persistent exposure of the delicate tissue of the esophagus to the acid content of the stomach can cause chronic inflammation of esophagitis. This can lead to a potentially serious condition called Barrett’s Esophagus.

At Duke, minimally invasive endoscopic and surgical treatments have proven to be safe, effective options to cure GERD and Barrett’s Esophagus. Learn to manage your GERD symptoms with the following tips:

  • Don’t eat dinner late
  • Eat snacks with low fat content
  • Exercise
  • Don’t smoke
  • Avoid acetic fruits and juices
  • Avoid spicy and seasoned food
  • Limit alcoholic beverage consumption
  • Avoid fried foods
  • Eat several smaller meals throughout the day
  • Limit soda consumption
  • Limit extra space
  • Avoid peppermint
  • Avoid exercising after you eat
  • Don’t sleep or lie down right after you eat
  • Talk to your doctor about finding a GERD treatment that is right for you

Learn more about treatment of GERD and Barrett’s Esophagus at a free seminar. Click here to register.

Endoscopic and Surgical Treatments for GERD

Gastroesophageal reflux disease (GERD) is a condition in which the contents of the stomach leak backward into the esophagus, or food pipe, causing irritation. (To learn more about the signs and symptoms check out yesterday’s post.)

Minimally invasive endoscopic and surgical treatments have proved to be safe, effective options to cure GERD for good. Stretta Therapy is a minimally invasive and effective bridge between drug therapy and reflux surgery for GERD. This innovative procedure uses radiofrequency energy to treat the muscle of the esophagus, remodeling the tissue and resulting in improved symptoms and a reduction or elimination of medication.

Stretta does not involve incisions or stitches and is performed in an outpatient setting. Stretta is for select patients who have failed to respond to lifestyle changes and drug therapy, who are concerned about the risks of long-term medication and who are not surgical candidates.

EsophyX TIF is a surgical procedure performed through the mouth, which reconstructs the barrier between the stomach and esophagus to prevent stomach fluids from refluxing up into the esophagus. EsophyX TIF involves no incisions, reduced recovery time and no visible scar.

Nissen Fundoplication is a surgical procedure that strengthens the “valve” between the esophagus and the stomach through the process of wrapping the upper curve of the stomach around the lowest portion of the esophagus. This results in stopping acid from backing up into the esophagus as easily. If a person has a hiatal hernia, which can cause GERD, it will also be repaired during this procedure.

The LINX Reflux Management System is a small flexible band made of interlinked titanium beads with magnetic cores that is placed around the esophagus. The magnetic pull between the beads is intended to help the Lower Esophageal Sphincter (LES) resist opening to gastric pressures, thus preventing reflux from the stomach into the esophagus. When swallowing normally, the LINX system is structured to expand, allowing food and liquid to pass normally into the stomach. The magnetic pull of the device is designed to close the LES immediately after swallowing, thus restoring the body’s natural barrier to reflux.

Weight Loss Surgery may be an effective option for individuals struggling with excess weight as traditional reflux procedures may not be as effective.

Barrett’s Esophagus
Over time, persistent exposure of the delicate tissue of the esophagus to the acid content of the stomach can cause chronic inflammation of esophagitis, which can lead to a potentially serious condition called Barrett’s Esophagus.

The Barrx Radiofrequency Ablation System utilizes high thermal energy delivered using a 3cm-long coil mounted on a balloon catheter. Ablation destroys abnormal cells to allow normal cells to re-populate.

Learn more about treatment of GERD at a free seminar. Click here to register.

GERD Signs and Symptoms

Studies show one in three people suffer from gastroesophageal reflux disease (GERD). GERD is a condition in which the contents of the stomach leak backward into the esophagus, or food pipe, causing irritation.

Symptoms of GERD include:

  • Heartburn
  • Hoarseness or sore throat
  • Chronic laryngitis
  • Regurgitation
  • Frequent swallowing or difficulty swallowing
  • Asthma or asthma-like symptoms
  • Pain or discomfort in the chest
  • Sleep disruption
  • Bloating
  • Excessive clearing of the throat
  • Persistent cough
  • Burning in the mouth or throat
  • Intolerance of certain foods
  • Dental erosions or therapy-resistant gum disease or inflammation

In addition to dietary controls, medications such as non-prescription antacids, proton pump inhibitors (PPIs) and H2 blockers help prevent the acceleration of GERD. Over time these medications may lose their effectiveness, requiring increased dosage. This can become expensive and risk long-term side effects. Check out our blog tomorrow to learn endoscopic and surgical treatments for GERD.

Fight Like a Girl: Free Breast Cancer Event

Fight like a girlBy age 30, a woman has a 1 in 227 chance of getting breast cancer. By the time she is 40, her chances increase to 1 in 68.* It’s not too early to learn how to fight like a girl when it comes to your breast health. Join a team of local providers as they discuss risk factors, screening, diagnoses, and treatment options for breast cancer. This free educational event will be held Thursday, September 11 from 7–8 pm in the Main Auditorium at Duke Regional Hospital.

Panel members include:
James Hathorn, MD
Regional Cancer Care

Bridget Koontz, MD
Radiation oncologist
Duke Regional Hospital

Amber Jarvis, MD
Durham Obstetrics and Gynecology

Aimee Mackey, MD
Surgical oncologist
Duke Regional Hospital

Come early. At 6:30 pm, our mammogram experts will share tips for breast self-exams and improving your mammogram experience. To register, click here or call 919-403-4DRH.

*Data provided by the National Cancer Institute.

Local College Baseball Coach Undergoes Surgery to Get Back in the Game

Mike Kennedy, head baseball coach at Elon University

Mike Kennedy, head baseball coach at Elon University. Photo courtesy of Elon Sports Information Department.

Over the course of two years Mike Kennedy of Burlington, NC, experienced constant pain in his right hip. As the head baseball coach at Elon University he was having trouble doing his job. Simple things like getting into various positions he was trying to show his players were difficult and painful. Mike decided he needed to make a change before the start of his eighteenth season as coach.

Mike, being only 45 years old, thought he was too young to need a hip replacement. However, his active past playing baseball, including time as a minor-league catcher, running for exercise and maintaining an active lifestyle, in combination with his size (6’-2”, 210 pounds), may have led to his hip’s early deterioration.

Mike visited Scott Kelley, MD, orthopaedic surgeon with North Carolina Orthopaedic Clinic, to find out what his options were for managing his hip pain. Dr. Kelley explained he needed surgery, but that Mike would know when it was time. He had tried Cortisone shots with some relief, but his hip finally told him it was time andMike had it replaced June 9, 2014. “It started restricting my everyday life because I’m active on the baseball field. If I had a desk job I might have waited longer, but for what I do I need to be able to move.”

While a hip replacement is a serious procedure Mike wasn’t uneasy before his surgery because Dr. Kelley came highly recommended. “I knew a couple people who had surgery by him before so I wasn’t nervous coming in.”

According to Mike, “Pre-op went fine. Dr. Kelley and his physician’s assistant Jamey (Messersmith) came in to check on me, Anesthesia came and then I woke up on the unit. The people at Duke Regional were nice, and the care was outstanding. I had surgery at 8 a.m., finished around 10 a.m. and was up walking by 1:30 p.m. The next day I had physical therapy, passed the test for discharge and was sent home. I only spent a little over 24 hours in the hospital.”

Mike’s first week after surgery was admittedly rough and included pain and stiffness. But since then, he has been getting better and better. He has been back to work watching games and feels close to normal. He’s also participating in outpatient physical therapy to help with his recovery.

Mike hopes to be back to his old self in eight months to a year. Just in time to add another winning season for the Elon University baseball team to the record books.

Spotlight on hernias

Jin Yoo, MD

Jin Yoo, MD

Hernias are common conditions that general surgeons see and treat on a daily basis. Surprisingly, they are often misunderstood from what they are and how they are treated from a public’s eye. A hernia is essentially a defect some place in the body where there shouldn’t be a defect. A defect may be a hole that shouldn’t be there (ventral/incisional hernias) or a hole that is naturally present but enlarged (hiatal, inguinal and parastomal hernias). Internal organs and intestines can traverse the defect and get partially or completely stuck, which can cause pain, or worse yet, strangulation of the internal organs that can lead to serious complications and even death. Therefore, if someone is diagnosed with a hernia, the general medical recommendation is to get it fixed unless the surgeon provides a compelling reason NOT to fix it. A common misunderstanding of hernias is that patients (and even some physicians) believe the hernia is the actual bulge the patient sees on the body, and they want this removed or cut out. Unfortunately, the bulge is actually the internal organ(s) that are bulging across the hernia defect, and therefore, that is not how hernias are treated. Hernias are fixed by correcting the defect.

What makes hernias even more complicated is that there are many types and they have their own special names. Here are some common hernias:

1) Inguinal hernia – this is a defect that arises from three potential sites in a person’s groin. Depending on the site, they are classified as indirect, direct or femoral.

2) Ventral hernia – this is a defect that arises on a person’s abdominal wall. Again, depending on the actual site and/or their cause, they are classified by names such as spigelian, incisional, epigastric and umbilical, to name a few.

3) Hiatal hernia – this is an enlargement of a naturally occurring hole in the diaphragm where the esophagus traverses from the chest into the abdomen before it turns into the stomach. The enlargement leads to the protrusion of the stomach up into the chest cavity resulting in reflux and obstructive symptoms when eating.

Again, the management of hernias is to surgically fix them as soon as a person is diagnosed with this condition UNLESS there is a compelling medical reason not to by the surgeon. Therefore, a surgical consultation is always recommended. The techniques by which hernias are fixed may drastically differ, but the general approach is to (1) put the “bulging” content back to its original location and to (2) fix the defect by closing up the hole or closing it down to its normal size.

To learn more about hernia surgery at Duke Regional, click here.

Hernia Awareness Month

According to the National Center for Health Statistics, some five million Americans have a hernia. Yet, only about 750,000 seek treatment each year.

A hernia is a bulge of an organ or tissue that patients may notice as a lump in their abdomen or groin. While some hernias develop suddenly, others can take more time, possibly as the result of weight gain, chronic constipation or pregnancy. Smoking and obesity are among the top risks for hernia formation and can cause complications following hernia surgery.

Duke Regional’s physicians are highly experienced at treating all types of hernias, no matter how complex their repair. Our physicians are leaders in minimally invasive surgery, and most hernia surgeries are performed laparoscopically.

Laparoscopic surgery is performed through small incisions and offers patients a quicker recovery than the conventional approach. If this is not possible, our surgeons have extensive experience with traditional open surgical techniques for repair of all types of hernias.

For more information about hernia repair click here or visit