GERD

GERD – Gastroesophageal Reflux Disease — the chronic acid reflux condition
It’s when stomach acid frequently flows back into the esophagus, irritating its lining. Common symptoms are heartburn, regurgitation, chest pain, and sometimes trouble swallowing.

Symptoms

Heartburn

Burning feeling in chest

Regurgitation

sour or bitter-tasting acid backing up into your throat/mouth

Chestpain

Difficulty swallowing

Feels like food is stuck

Chronic cough

Sore throat, or hoarseness

Feeling like you have a lump in your throat

Main Causes

Weak lower esophageal sphincter (LES) muscle

Burning feeling in chest

Certain foods and drinks

spicy foods, coffee, alcohol, etc.

Hiatal hernia

Obesity

Pregnancy

Smoking

Treatment

Lifestyle changes

  • Lose weight if needed
  • Eat smaller meals
  • Avoid lying down after eating
  • Elevate the head of the bed
  • Avoid trigger foods (spicy, fatty, citrus, caffeine, chocolate)

Medications

  • Antacids (like Tums, Maalox)
  • H2 blockers (like famotidine/Pepcid)
  • Proton pump inhibitors (PPIs like omeprazole/Prilosec)
Surgery
Nissen Fundoplication (the most common one)
  • The surgeon wraps the top of the stomach (fundus) around the lower esophagus.
  • This strengthens the valve (LES) so acid can’t flow back.
  • Can be done laparoscopically (small cuts, faster recovery).
  • High success rate — many people don't need reflux meds afterward!

Achalasia Cardia

It’s a rare disorder where the lower esophageal sphincter (LES) (the valve between your esophagus and stomach) doesn’t relax properly. Also, the muscles of the esophagus lose their ability to push food down. So, food and liquid get stuck in the esophagus instead of reaching the stomach.

Causes

  • The exact cause is unknown
  • It’s thought to involve nerve degeneration in the esophagus.
  • Could have autoimmune or viral triggers.

Symptoms

  • Difficulty swallowing (both liquids and solids)
  • Chest pain or tightness after eating
  • Regurgitation of undigested food (especially at night)
  • Weight loss
  • Coughing or choking, especially when lying down
  • Feeling like "food gets stuck"

Diagnosis

  • Barium swallow X-ray (shows "bird's beak" appearance)
  • Esophageal manometry (measures the muscle movement — gold standard)
  • Upper endoscopy (to rule out other causes like cancer)

Treatment

Achalasia can’t be “cured,” but it can be managed very well:

Pneumatic Dilation

  • A balloon is inserted and inflated to stretch the LES
  • Sometimes needs to be repeated

Heller Myotomy Surgery

  • The surgeon cuts the muscles at the LES so it can open properly
  • Often done laparoscopically (small incisions)

POEM (Peroral Endoscopic Myotomy)

  • A newer technique — done through the mouth with an endoscope.
  • No outside incisions

Botox Injections

  • Temporary option where Botox is injected into LES to relax it
  • Good for people who aren't good surgical candidates

Medications

Sometimes used (like nitrates or calcium channel blockers), but not super effective long-term.

Esophagus Cancer

Cancer that forms in tissues of the esophagus — the long, hollow tube that carries food from your throat to your stomach

Types

The main types of pancreatic cancer include:

Squamous Cell Carcinoma

Starts in the flat cells lining the esophagus.

Adenocarcinoma

Starts in cells that make mucus and other fluids, usually lower in the esophagus.

Symptoms

Trouble swallowing (dysphagia)

Chest pain or burning

Weight loss without trying

Difficulty swallowing

Feels like food is stuck

Chronic cough

Sore throat, or hoarseness

Feeling like you have a lump in your throat

Risk Factors

Smoking and heavy alcohol use

Long-term acid reflux (GERD)

Obesity

Excess body weight is associated with a higher risk

Barrett’s esophagus

A condition from long-term reflux

Age

Most common after 60 years

Diagnosis

Endoscopy

Camera into the esophagus

Biopsy

Tissue sample

Imaging

CT scan, PET scan

Treatment Options

  • Surgery to remove cancer
  • Chemotherapy
  • Radiation therapy
  • Targeted drug therapy or immunotherapy (newer options)

Main Types of Esophagus Cancer Surgeries

Esophagectomy

  • Most common
  • Removes part (or all) of the esophagus.
  • Sometimes part of the stomach and nearby lymph nodes are removed too.
  • The stomach (or sometimes a piece of the intestine) is then pulled up to reconnect with what's left of the esophagus.

Esophagogastrectomy

  • Removes the esophagus and the top part of the stomach.
  • This is usually done when the tumor is lower down near the stomach.

Surgery Techniques

Open surgery

Traditional method — large cuts in the chest and/or abdomen

Minimally invasive surgery (MIS)

Small cuts + tiny cameras and tools (laparoscopy/thoracoscopy)

Robotic surgery

A surgeon uses a robot for very precise movements.

Risks and Challenges

  • Infection
  • Leakage where the esophagus and stomach are reconnected
  • Breathing problems (since it's close to the lungs)
  • Difficulty swallowing (might need therapy later)

Recovery

  • Hospital stay: usually 1–2 weeks
  • Full recovery: several months
  • May need a feeding tube temporarily during healing
  • Difficulty swallowing (might need therapy later)
  • Surgery is often combined with chemotherapy or radiation before (neoadjuvant therapy) to shrink the tumor, or after (adjuvant therapy) to kill any remaining cancer.
  • Not everyone is a candidate — it depends on the cancer stage and general health.

Stomach Cancer

Stomach cancer happens when cells in the lining of the stomach grow uncontrollably, forming a tumour. Over time, it can spread to nearby lymph nodes, organs, or even distant parts of the body.

Symptoms

Early stomach cancer often doesn’t cause clear symptoms, which makes it hard to catch early. As it grows, you might notice:

Indigestion or heartburn

Feeling full after eating a small amount

Stomach pain

Nausea or vomiting

Weight loss without trying

Blood in stool

Can look black or tarry

Difficulty swallowing

If the tumor is near the top of the stomach

Risk Factors

A bacteria that causes ulcers

A condition from long-term reflux

Smoking

Tobacco use raises the risk

Family history

Family history of stomach cancer

High-salt diet

Smoked or pickled foods

Age

More common after age 50

A bacteria that causes ulcers

A condition from long-term reflux

Male gender

Men are more at risk

Diagnosis

Upper endoscopy

Camera tube into the stomach

Biopsy

Taking a small piece of tissue to look at under a microscope

Imaging

CT scan or PET scan to see if cancer has spread

Blood tests

Sometimes tumor markers

Treatment Options

Depends on the stage (early or advanced):

Stage
Common Treatments

Early

Endoscopic surgery, Partial gastrectomy

Localized (bigger tumor but not spread far)

Gastrectomy (stomach removal) + Chemotherapy

Advanced/metastatic

Chemotherapy, targeted therapy, immunotherapy

Stomach cancer surgery (also called gastrectomy) is one of the main treatments for stomach (gastric) cancer, especially if the cancer is still localized and has not spread extensively.

There are a few types of surgeries depending on the size and location of the tumor:

Subtotal (Partial) Gastrectomy

  • Only part of the stomach is removed.
  • Often used if the cancer is located in the lower part of the stomach

Total Gastrectomy

  • The entire stomach is removed,
  • Necessary if the cancer is widespread throughout the stomach.

Endoscopic Mucosal Resection (EMR) or Endoscopic Submucosal Dissection (ESD)

  • Minimally invasive procedures used for very early-stage stomach cancers
  • Done through an endoscope without cutting the body open.

Palliative Surgery

  • If the cancer cannot be completely removed, surgery might still be done to relieve symptoms (like bleeding, obstruction).