Gastroenterology Consultants,SC: Diseases of the GI tract GASTROESOPHAGEAL REFLUX DISEASE (GERD) [<<back | list all>>] Heartburn is caused by stomach acid refluxing or splashing up into the esophagus--the muscular tube that connects the throat to the stomach. Anyone who has heartburn on a regular basis should consult a physician. Constant exposure to stomach acid can irritate the lining of the esophagus and cause other medical problems including Barrett's esophagus . Serious heartburn is known as gastroesophageal reflux disease or (GERD). At the lower end of the esophagus where it enters the stomach, there is a strong muscular ring called the lower esophageal sphincter (LES). The LES should remain tightly closed, except to allow food and liquid to pass into the stomach. Reflux occurs when the LES is not working properly. It may relax for periods of time throughout the day and night, or it may be constantly too weak to function effectively. This allows the stomach's acid juices to flow into the esophagus. Currently there are four treatment options for GERD. Acid controlling medications Laparoscopic Anti-Reflux surgery Endoluminal Gastroplication (Endocinch) Stretta The last two are procedures done on an out-patient basis. Patients are sedated, and each prodedure takes approximately 30-40 minutes. There is a short observation period after and then the patient is allowed to go home and resume normal activity the next day with few alterations in the diet. Endoluminal Gastroplication uses "The Endo-Cinch" system, which creates a plication or pleat at the lower esophageal sphincter. The system, like a tiny sewing machine, is attached to the end of a standard flexible endoscope. This direct visualization of the lower esophageal sphincter allows the physician to place a stitch in the correct area. Two stitches can be placed and tied together to create a pleat. The Stretta procedure utilizes radio-frequency energy, an energy waveform which is used in many medical specialties for coagulating or heating tissues. In G.I., radio-frequency is used to tighten the valve between the stomach and the esophagus.