Esophageal and Gastric (Foregut) Diseases

For Foregut Diseases, our team provides comprehensive, multidisciplinary and expert surgical and endoscopic care for the treatment of esophageal and gastric cancer, Gastroesophageal Reflux Disease (GERD), Barrett’s Esophagus, Paraesophageal Hiatal Hernias, Gastroparesis, and Esophageal Achalasia among others. 

Our team provides comprehensive, multidisciplinary and expert surgical and endoscopic care for the treatment of conditions like:

• Esophageal and gastric cancer
• Gastroesophageal Reflux Disease (GERD)
• Barrett’s Esophagus
• Paraesophageal Hiatal Hernias
• Gastroparesis
• Esophageal Achalasia

We work in close collaboration with our colleagues in Gastroenterology, Radiology, Endocrinology, and other specialties at VCU Health to provide the latest technology and a true multidisciplinary view of the problem at hand. This promotes for greater accuracy in diagnosis and better therapeutic decisions for all foregut diseases.

Gastroesophageal Reflux Disease (GERD)

Approximately 10 to 20 percent of people in the United States have the most common symptoms of gastroesophageal reflux disease (GERD): heartburn, regurgitation, and dysphagia. (Less common symptoms include bronchospasm, laryngitis, chronic cough, chest pain, and others.)

Symptoms are considered clinically significant if they occur in a mild form two or more days per week, or in a moderate to severe form more than one day per week.

When to consider surgery

For patients with mild GERD, symptoms may improve by losing weight, changing diet, and/or taking antacids, H2 blockers, or proton pump inhibitors. However, surgical treatment may be recommended for those who do not wish to stay on medications permanently to control their symptoms, or when medication does not completely relieve symptoms. Sometimes, patients cannot take medication long-term, this could be due to fear of short term or long-term side effects. If a patient has asthma, hoarseness or a cough that does not improve with medication, they may also want to consider surgery. 

Minimally Invasive Endoscopic & Surgical Options

The type of therapy chosen is tailored to individual patient characteristics such as age, presence of a hiatal hernia, how well the esophagus works and others.

The minimally invasive endoscopic and surgical treatment options for patients with well-established GERD are:

• Laparoscopic Anti-reflux Surgery (LAR) – this the most common surgical treatment for GERD.
• LINX® Reflux Management System
• Endoscopic Stretta Therapy®

Esophageal Achalasia

Surgical treatment options include:

• Lap Heller Myotomy
• Endoscopic Balloon Dilation
• Per-Oral Endoscopic Myotomy

Gastroparesis

Surgical treatment options include:

• Enterra® Therapy
• Lap Surgical Options

Our team also offers laparoscopic repair for Paraesophageal Hernias as well as minimally invasive treatments for esophageal and gastric cancer.