What Your Gut Should Tell You: Esophageal Health Requires an Experienced Team

Reflux and other esophageal issues require prompt diagnosis and treatment to prevent more serious health concerns, including chronic indigestion or rarely, cancer. The Esophageal Center of Excellence at Virginia Mason brings a multidisciplinary approach to treatment that includes experts in interventional radiology, oncology, nursing and pathology.

“Multidisciplinary care allows us to provide the treatment that is most appropriate and most effective,” says gastroenterologist Andrew Ross, MD.

stomachePublished outcomes show that innovative care at the Esophageal Center results in shorter hospital stays, better cancer survival rates and a better quality of life after surgery. “Our excellent outcomes are attributable to our commitment to clinical research and publication,” says Donald Low, MD, director, Esophageal Center of Excellence. “We are always on the forefront of research that allows us to use the newest and best treatments.”

Virginia Mason has the highest volume of esophageal resections in the Pacific Northwest, with 75 percent of patients traveling 150 miles or more to receive care. Esophageal specialists also developed the only anti-reflux procedure originating in North America.

GERD and Acid Reflux

The Esophageal Center is known for its innovative and successful treatment of the related conditions of acid reflux and gastrointestinal reflux disease (GERD), a chronic condition frequently caused by inappropriate relaxation of the lower esophageal sphincter.

GERD requires prompt treatment to avoid additional health problems that include esophageal ulcers, chronic cough, irritation of the esophagus and other serious conditions. Smoking, obesity, pregnancy and certain medications may predispose a person to experience GERD.

Symptoms of GERD include the sensation of a lump behind the breastbone, nausea after eating and heartburn. GERD is treatable in the overwhelming majority of patients with dietary and lifestyle changes, medications and/or surgical intervention.

Medications generally work by making the stomach juices less acidic. They do not fix the underlying reason for GERD, which leads to a recurrence in symptoms once medications are stopped.

There have been some controversial studies regarding the safety of long-term use of some medications to treat GERD. It is best for patients to rely on the lowest possible dose that results in control of symptoms. Concerns regarding calcium metabolism and osteoporosis mean that patients using these medications for longer periods may need to have their bone density monitored, and should check with their physician to see if tests are indicated.

Long-term GERD can, in rare cases, lead to the development of esophageal cancer. Patients with long-term (greater than 5-10 years) of symptoms, especially middle-aged white men, should ask their doctor about undergoing an endoscopy to evaluate for pre-cancerous changes of the esophagus. Patients who develop difficulty swallowing, weight loss, blood in the stool or anemia should see their doctor immediately.

Barrett’s Esophagus

Barrett’s Esophagus is a condition of GERD that occurs when the tissue in the esophagus begins to take on the characteristics of the tissue in the intestines. Although this is considered a pre-cancerous condition of the esophagus, most patients with Barrett’s esophagus will never develop esophageal cancer in their lifetime. In patients with Barrett’s esophagus, routine exams of the esophagus and upper digestive systems may help ensure that any cancerous or pre-cancerous cells are found and treated early.

Esophageal Cancer

Esophageal cancer patients who have undergone surgery at Virginia Mason have some of the best reported outcomes in the world. An analysis of one 20-year period (1991-2011) showed a postoperative mortality rate of less than 0.5 percent compared to the national rate of 8.9 percent.

In addition, recent data from the National Cancer Data Base demonstrate that patients at Virginia Mason have better esophageal cancer survival rates at every stage of the disease. Physicians from around the world have visited Virginia Mason to study the clinical pathways that have led to the best possible management of esophageal cancer.

This management includes regular multidisciplinary cancer conferences and support groups that benefit patients, physicians and staff, who gain better insight into and understanding of specific esophageal disorders. At Virginia Mason, care supported by an esophageal cancer nurse navigator and continuous communication help ensure the best results, and ultimately the best quality of life for patients.

The Esophageal Center of Excellence provides comprehensive care for a range of esophageal and gastrointestinal issues. If you have questions or are experiencing symptoms, please call us at
(206) 223-2319.

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