Dignity Health | hello Healthy | Winter 2018-2019

6 DignityHealth.org/Bakersfield | Winter 2018–2019 bur heart GERD: More than When Edward Taylor III, MD, a general surgeon at Dignity Health – Mercy and Memorial Hospitals, started researching gastroesophageal reflux disease (GERD) more than 20 years ago, no one really considered it a true disease. He and his medical counterparts soon realized that its severity and frequency greatly merited further investigation. While the disease is often associated with heartburn, several other symptoms may indicate whether a person has GERD. Symptoms to watch out for Approximately one-third of individuals in the U.S. have GERD and experience classic symptoms of acid reflux, such as heartburn and regurgitation. Additional GERD symptoms may include chronic cough, chest pain, belching, difficulty swallowing, a sensation of a lump in the throat, chronic pneumonia, hoarseness, laryngitis, and worsened asthma. In severe cases of GERD, patients may have anemia due to blood loss. Diagnosing the problem With the increased availability of over-the-counter medications for treating GERD, people have been able to self-diagnose and self-treat with medications called proton pump inhibitors (PPIs). A primary care physician may also advise using this type of medication as a first step toward diagnosing the problem. “Those inhibitors work so well, it’s one strong way to diagnose GERD,” Dr. Taylor says. “It’s uncommon the symptoms wouldn’t get better upon implementing this therapy. If the PPIs don’t make the symptoms better, the problem may lie elsewhere.” If a patient has been experiencing GERD for five years or more, they may start to develop what Dr. Taylor terms alarm symptoms: difficulty swallowing, bleeding, anemia, or chest pain. At that point, a specialist will perform an esophagogastroduodenoscopy (EGD) in order to rule out esophageal injury, which can lead to narrowing of the esophagus and precancerous changes to cells in the esophagus (called Barrett’s esophagus). Caucasian males over age 45 who have had GERD for more than four years should also consider undergoing an EGD. This patient population is at a significantly increased risk of developing esophageal cancer. Dr. Taylor warns that people should not continue self-medicating for an extended period without medical intervention, as doing so may mask more serious underlying issues. “It is a bit risky to just keep treating yourself with over-the-counter options, because precancerous changes may occur without previous symptoms returning,” he explains. “That’s part of the danger with the medications working so well.” Proceed with caution Dr. Taylor’s strongest piece of advice is to not underestimate any symptoms potentially related to GERD. They may eventually lead to more serious conditions, such as Barrett’s esophagus, which increases the risk for esophageal cancer. A person’s likelihood of developing Barrett’s esophagus is directly correlated with how long they have GERD. “Definitely don’t ignore this disease,” Dr. Taylor says. “It doesn’t necessarily mean you need surgery, but you certainly don’t want to ignore it for 20 years.” Edward Taylor III, MD, is a general surgeon at Dignity Health – Mercy and Memorial Hospitals. Dr. Taylor has more than 25 years of experience in general surgery, has held several academic and faculty appointments, and is a fellow of the American College of Surgeons. He has given countless lectures on laparoscopic surgery topics, including fundoplication, and has published numerous research articles on a variety of clinical topics.