Upper Endoscopy - also known as an esophagogastroduodenoscopy or EGD - uses an endoscope (a lighted, flexible tube, about the thickness of a finger) to examine the upper gastrointestinal tract while you are sedated. The EGD examines the esophagus, stomach, and duodenum, which is the first part of the small intestine. A special instrument may be passed through the tube to take a small piece of tissue (a biopsy) for examination in the laboratory.

Uses a thin probe that goes through the nose into the esophagus, and is connected to an external data recorder. The recorder measures the amount of reflux (both acidic and non-acidic) traveling into the esophagus. The patient goes home with it for a day, keeps a diary of symptoms, and returns the next day to have it removed.

Uses a pH sensor that is temporarily attached to the wall of the esophagus at the time of an upper endoscopy. Using radio waves, the data is transmitted wirelessly to the external data recorder. This provides data on acid reflux, but not non-acidic reflux. 

Uses a thin catheter placed through the nose into the esophagus, to measure pressures and coordination of the esophagus while the patient takes sips of water. This helps us rule out rare causes of regurgitation, is needed to accurately place the pH/impedance sensor, and is important to determine whether surgery would be appropriate. We utilize high-resolution esophageal manometry, which gives much greater detail in the swallowing mechanism than the previous technology, which is still often in use at other medical centers.

Lifestyle changes may be helpful in relieving some GERD symptoms. Your doctor may ask you to avoid certain foods that can make your symptoms worse, such as chocolate, alcohol, coffee, citrus, and tomato-based products. Other recommendations may include losing weight, raising the head of your bed and quitting smoking. 

Over the counter and prescribed medications can help relieve symptoms and/or decrease the acid produced from the stomach. 

Surgery may be recommended for patients with typical GERD symptoms, but who have had a partial response to medication, have had other conditions excluded, and who have GERD documented using ambulatory pH/impedance monitoring.

Laproscopic antireflux is a minimally invasive surgery that was pioneered at U-M combining the features of a Collis gastroplasty and Nissen fundoplication procedures. This procedure reduces the risk of recurrent gastroesophageal reflux that may be encountered after the more traditional treatments and when symptoms are poorly controlled by medical therapy or have associated complications such as esophageal stricture or relative shortening of the esophagus. Average hospital stay is two days, and patients are able to return a normal lifestyle within one week.