Transcription:

Introduction: St. Joseph's health presents another edition of its podcast St Joseph's Health Med Cast.

Bill Klaproth: Many people suffer from gastroesophageal disease or GERD or more commonly known as heartburn. So how do you know if you have it, when is it time to see the doctor and what are the treatment options? Let's find out more with Dr. Atul Maini, head of the Heartburn Center or HBC at St. Joseph's Health. Dr. Maini, thank you so much for your time. So first off, how common is heartburn?

Dr. Maini: Thanks for having me. Heartburn is an extremely common problem. In fact, one in five adults or 20% of US population will have experienced heartburn with very large number of hospitalizations and about 64 million prescriptions. And this is actually not taking into consideration all the over the counter medications. It's one of the largest and fastest growing disease in the United States.

Host: Wow. Those are pretty surprising numbers. So how does someone know when it's time to seek treatment?

Dr. Maini: So I think we recommend to patients that it is important to have a conversation with your doctor. Many of the patients seek treatment when they continue to experience breakthrough symptoms after taking medications. I think the key is that when they are experiencing chronic symptoms or long-term medications, they are taking over the counters, that's a time to start a conversation with your primary physicians or your GI doctors, to see how to manage these.

Host: Yeah, that makes sense. So I know heartburn sometimes may share symptoms with other things. So how do you diagnose heartburn?

Dr. Maini: So at our center, we have a very well defined protocol, which includes an extensive workup to diagnose heartburn, requires certain x-rays, maybe endoscopies by our GI colleagues, and a couple of the investigation that done before we definitely term it as a significant pathological heartburn.

Host: So how would someone know if they have GERD or heartburn?

Dr. Maini: Patients will feel, you know, chest pain, acid reflux in their mouth, cough and other kinds of symptoms. But a real proper diagnosis is made in conjunction with your physician. And with the help of extensive workup as I described just now, but there are common symptoms that patients have, which I described. And so those are the initial symptoms which should trigger the further workup.

Host: Is heartburn really a big deal? I mean, some people probably just, eh, this is an annoyance and I'm going to live with it. What can happen if heartburn is not treated?

Dr. Maini: So, yeah, you're right. You know, a lot of people think that it's just a heartburn, I'll pop some medications over the counter. But the problem is that if you have a chronic heartburn and if it's left untreated, unfortunately it has the capability to change the inner lining of the esophagus or the food pipe. And if this is left unchecked, this can lead to something called Barrett's esophagus and then that places a patient to a 40 times greater risk of developing esophageal cancer in their lifetime. So it is really a big deal.

Host: That is a big deal. Okay. Not good. Okay. So how do you treat heartburn? What are the available treatments?

Dr. Maini: Fortunately, there are treatment options that have proven effective in management of gastroesophageal reflux disease or heartburn. We offer support and guidance. We started lifestyle modifications, medical management, and if necessary, surgical management. We do at our center offer cutting edge surgical treatments. We perform them robotically, which means that we are the only provider in the area to perform Lynx procedure, which is a latest procedure for entire reflux, surgical management. So the options are here and patients no longer have to manage their disease state with over the counter or only medications.

Host: Wow, that's really interesting. So it is then possible to manage this without medications.

Dr. Maini: It is and majority of times in patients who will qualify, and surgical options can be offered. There are other options also. In fact, we offer to patients, which includes weight loss, smoking cessation, alcohol cessation, dietary modifications. So we really are a center one to understand the disease process and then recommend a full range of treatment options or eliminate symptoms so they can go back to enjoying their life.

Host: Right. So with simple lifestyle changes, you can also manage this as well depending on the severity. So are there, you were talking about medications, are there side effects of medications used to treat GERD?

Dr. Maini: Yeah, there are actually extensive side effects for chronic use of these medications. And I want to emphasize it's chronic. It's not like you have tried it for a week and you will, you will get in trouble. It's not like that, but patients can have chronic kidney disease, cardiovascular disease, cerebrovascular disease, dementia and there is some association between osteoporosis, vitamin and mineral deficiencies, bacterial overgrowth in your GI track, and infections and gastric polyps and even cancer can be seen in patients who are chronically suppressing their assets with these medications for a long time.

Host: So we've established this can be a serious problem. Let me ask you this, since some of the symptoms may be common with other conditions, what are some symptoms of heartburn that may be overlooked?

Dr. Maini: That's a great question. Some of the patients we see in our center actually do not even have heartburn symptoms. They come to us with symptoms which are non GI tract symptoms like chronic cough, shortness of breath, they have been treated for COPD their entire life, hoarseness, sore throat and even teeth erosion. We have a significant number of patients being referred to us from dentist’s office now because they realize that teeth erosion is the first sign in some patients of reflux disease. So patients sometimes don't even know they have reflux until they go and visit the dentist and they see teeth erosion. So these are easier symptoms to be overlooked or actually mistreated. In fact they have a reflux problem.

Host: So Dr. Maini, can you tell us what is unique about the heartburn center at St. Joseph's Health or HBC?

Dr. Maini: So we are the only center office coined with a comprehensive approach. And what I mean by that is we have a program where GI doctors, the surgeons, the program director and coordinator sit together as an experienced team we have formed that would provide an insight into patient diagnosis and then management treatment plan. So this kind of management has been proven multiple times to have better outcomes and that's why it works better. And we are the only center of its kind in upstate New York, which is so comprehensive in nature.

Host: Overall. Then why is this comprehensive approach really important or beneficial?

Dr. Maini: Because if you go to your GI doctor individually in an office and then you go to your surgeon and then you go to your primary doctor, your care is actually fragmented in a center where we all sit together in one room and we talk about your studies and your work up and your lifestyle modification and your treatment. It has a treatment plan which is agreed upon with all the physicians involved. We have discussions about patient and then a plan, what kind of surgical management or what kind of modification we required to give you the best option of treatment.

Host: Well, it's really good to know that we have the HBC right here to take care of these chronic type conditions as we talk about heartburn and GERD. This has been really fascinating, Dr. Maini, thank you so much.

Dr. Maini: Thanks for having me.

Host: That's Dr. Atul Maini, head of the Heartburn Center or HBC at St. Joseph's Health. And for more information, please visit SJHSYR.org. And if you found this podcast helpful, please share it on your social channels and check out the entire podcast library for topics of interest to you. This is St. Joseph's Health Med Cast from St. Joseph's Health. I'm Bill Klaproth. Thanks for listening.