Types of specialists and when to consult them
Gastroesophageal reflux disease (GERD) is a common condition that causes acid reflux (heartburn) at least several times a week. GERD symptoms can interfere with daily activities or a good night’s sleep.
If heartburn is part of your everyday life, it might be time to see a doctor who specializes in GERD.
In this article, we will review the types of specialists who treat GERD. We’ll also clarify symptoms that might indicate you need a specialist.
When you eat or drink, food travels from your mouth to your stomach through a tube called the esophagus. GERD symptoms occur when stomach contents back up through the esophagus into the chest. This causes the burning sensation most associated with GERD.
Anyone can have occasional heartburn. GERD differs from ordinary heartburn in its frequency and, in some cases, severity.
These common symptoms of GERD may require consultation with a specialist:
- heartburn that occurs more than twice a week
- heartburn that does not improve with the use of antacids
- acid reflux that wakes you up at night
- regurgitation of sour liquid or food particles from the stomach into the throat and mouth
- chest pain
- sore throat
- difficulty swallowing
- feeling of a lump in your throat
- bad breath
Lifestyle Changes That May Help GERD Symptoms
GERD symptoms can improve with lifestyle changes, such as:
- maintain a moderate weight
- try to quit smoking, if you smoke
- eliminate or reduce consumption of coffee, alcohol, and soft drinks
- eating smaller meals, especially at night
- do not eat late at night
- not lying down for at least 3 hours after eating
- eliminating spicy, fatty and acidic foods from your diet
If lifestyle changes do not eliminate these symptoms, it may be worth seeing a GERD specialist. A GERD doctor can do medical tests that uncover the underlying cause of your symptoms. They can also provide advice on how to manage GERD.
Babies, children, and adults can have GERD. Talking with your GP or your child’s pediatrician is a good first step in treating GERD. They can prescribe medications that ease symptoms and can provide information about next steps.
In many cases, your GP will recommend that you see a gastroenterologist or other type of specialist for testing and treatment.
Gastroenterologists are board-certified physicians who receive specialized training to treat conditions of the gastrointestinal tract and liver. Gastroenterologists are the type of specialists usually consulted for the diagnosis and treatment of GERD.
Depending on your symptoms, your GP may recommend you see an ear, nose and throat specialist instead. They are also known as ENT or ear, nose and throat specialist. If you have stomach acid spilling into your throat or voice box, you may have laryngopharyngeal reflux (LPR) instead of or in addition to GERD. Ear, nose and throat doctors have experience diagnosing and treating both conditions.
Nutritionist or dietitian
Coaching from a nutritionist or dietitian may also be beneficial in helping you maintain a moderate weight. Nutrition specialists may also recommend lists of foods to eat or avoid for GERD management. These types of specialists do not replace gastroenterologists or ENT specialists. They can, however, help with lifestyle choices and symptom management.
GERD physicians, such as gastroenterologists, receive extensive training to perform endoscopic procedures and interpret their results. GERD specialists are equipped to perform diagnostic tests that uncover underlying causes and conditions that mimic GERD.
Conditions that can mimic GERD include:
Diagnostic tests that a GERD specialist may do include:
- Upper endoscopy. This procedure is done under light anesthesia. A flexible tube with a small camera is placed in the esophagus to examine it. Your doctor may remove a small piece of esophageal tissue for a biopsy during an upper endoscopy.
- Esophageal pH monitoring. For this test, a small monitor is placed in your esophagus to analyze how your gastrointestinal system manages and regulates the flow of stomach acid over the course of several days.
- Esophageal manometry. During this test, a tube is placed into the esophagus through the nose to measure the strength of the esophageal muscles.
- Esophogram. For this test, you will first drink a barium solution and then have an x-ray of your upper digestive tract.
- 24 hour ambulatory pH probe. During this test, a tube is placed into the esophagus through the nose and left in place for 24 hours. A pH sensor in the tube measures acid levels in the esophagus.
After testing and diagnosis, you may be placed on medication and monitored. In some cases, a specialist will recommend that you continue to see him for follow-up and treatment. In other cases, they may instead recommend that you visit your GP regularly for follow-up.
If your symptoms don’t improve, a GERD specialist may recommend other treatments, such as surgery or non-incisional transoral fundoplication (TIF). Although not as widely used as surgery, a FIT procedure (also called a Stretta procedure) is beginning to be used more often in clinical practices. This minimally invasive, non-surgical procedure repairs the anti-reflux barrier inside the stomach.
In some cases, diagnostic tests may show that a hiatal hernia is causing the symptoms of GERD. Hiatal hernias are often treated with an outpatient laparoscopic procedure, such as a
Surgery for GERD and its underlying causes can only be performed by a specialist in GERD.
Your GP may be able to refer you to a GERD specialist. If you have health insurance, your insurer may also be able to provide you with a list of specialists practicing in your area. You can also search for patient referrals online.
What to consider when choosing a specialist
When choosing a specialist, keep these considerations in mind:
- How many years have they been practicing their specialty?
- What is their experience in treating your condition?
- Have any complaints been registered against them in the Federation of State Medical Boards‘ DocInfo database?
- If surgery is needed, how many times a week does he perform the surgery you need?
- Do they accept your insurance?
- How comfortable do they make you feel?
- Are they patient enough to answer all your questions without rushing you during the appointment?
- Does their office follow local COVID-19 safety guidelines?
Gastroesophageal reflux disease (GERD) involves excessive or extreme episodes of heartburn.
A GERD doctor such as a gastroenterologist is usually the best choice for diagnosing and treating this condition. In some cases, an ENT specialist may also be used to diagnose and treat GERD.