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    Gastroesophageal Reflux Disease (GERD) in New Jersey

    GERD affects adults as well as children of all ages. The Digestive Health & Nutrition Center has two convenient locations in Lawrenceville and Princeton New Jersey where you can receive the exceptional care you deserve. Gastroenterologist Angela Merlo, M.D. has special expertise in the diagnosis and treatment of GERD.

    What is GERD?

    Occasional acid reflux is normal.  Symptoms develop when acid reflux occurs more frequently. Frequent and prolonged reflux of stomach acid into the esophagus can damage the lining of the esophagus and lead to complications. GERD means Gastroesophageal Reflux Disease. GERD is the term used when symptoms of acid reflux or its complications are present or suspected. Inflammation of the esophagus need not be present for GERD. Reflux esophagitis is the tem used for the subset of people with GERD who also have esophageal inflammation on endoscopy or biopsy. Only about half of untreated people affected with GERD have reflux esophagitis. GERD is highly prevalent and affects a great many individuals of all ages including children.

    What are the Symptoms of GERD?

    Gastroesophageal Reflux Disease (GERD) can present with a wide array of symptoms. The most common are:

    • Burning in the chest
    • Pain beneath the sternum
    • Regurgitation or the taste of sour stomach fluid

    However, some affected individuals with GERD do not feel heartburn or pain but have:

    • Asthma
    • Belching
    • Chronic cough
    • Hoarseness
    • Nausea

    What Causes GERD?

    GERD results from the prolonged exposure of the lining of esophagus to stomach fluids.  Stomach fluids contain acid as well as other potentially damaging substances.  Normally, a muscular valve at the end of the esophagus prevents stomach fluids from entering the esophagus. This valve is called the lower esophageal sphincter or LES. GERD occurs when the LES is too weak and when the LES relaxes too frequently or stays relaxed for too long.  Certain medications and some medical conditions can affect the functioning of the LES and lead to GERD.

    How is GERD Diagnosed?

    The diagnosis of GERD is sometimes based on symptoms alone. But, accurate diagnosis is crucial. Other forms of esophagitis (LINK) present with similar symptoms. And, severity of symptoms does not predict severity of GERD.  Specialized tests are recommended to

    • Exclude other forms of esophagitis (LINK)
    • Assess severity of disease
    • Diagnose complications
    • Monitor treatment

    Dr. Merlo has expertise in these technologically advanced procedures to provide her patients with the most accurate diagnosis and assessment of disease. She can then formulate the best treatment plan for your individual situation.

    • Upper Endoscopy or EGD (LINK) is the most commonly performed procedure for both visual assessment and microscopic analysis of biopsies
    • Esophageal Manometry, High Definition with Impedence (LINK) measures pressures within the esophagus to assess swallowing function and the functioning of the lower esophageal sphincter.
    • pH Monitoring provides a direct measure of acid within the esophagus.

    What are the Complications of GERD?

    Chronic exposure of the lining of the esophagus to stomach acid can create serious health problems.  These include

    • Stricture and stenosis as a result of scarring from acid injury
    • Barrett’s Esophagus (LINK) when the lining of the esophagus becomes transformed
    • Esophageal Cancer (LINK)

    Treatment for GERD

    The most critical factors for success of any treatment are lifestyle changes:

    • Stop tobacco
    • Limit alcohol consumption
    • Maintain a healthy weight
    • Limit caffeine and chocolate consumption
    • Do not lie down for two hours after eating or drinking
    • Avoid use of anti-inflammatory medications

    Lifestyle changes may not be enough to adequately control your GERD. Fortunately, there are a variety of medications available that neutralize acid, block the effects of acid or suppress acid production to restore health. Surgery is rarely necessary.  Dr. Merlo will be happy to address your concerns and formulate a treatment plan that is right for you.

    If you are seeking a Gastroenterologist specialist with expertise in diagnosing and treating GERD, call Digestive Health & Nutrition Center for an appointment with Dr. Merlo at either the Lawrenceville or Princeton location. Dr. Merlo treats adults as well as children with GERD.