The lower esophageal sphincter or LES is damaged by the chronic digestive condition known as gastro-esophageal reflux disease (GERD). This LES serves as a valve between the stomach and the esophagus. When the lower esophageal sphincter (LES) is working properly, it will first open to let food and drink into the stomach, and then it will close to establish a barrier between the esophagus and the acid in the stomach. Heartburn, chest pain, regurgitation, a sore throat, and cough are some of the symptoms that can be caused by a weak lower esophageal sphincter (LES). A weak LES will not close correctly and will allow stomach acid to wash back into the esophagus, which will often cause injury to the lining of the esophagus.

Patients who have gastroesophageal reflux disease have a lower esophageal sphincter that is either weaker, shorter, or has shifted into a region that is not normal due to a hiatal hernia, which causes it to relax in an incorrect manner. When this happens, it can cause unpleasant sensations because it allows stomach acid, bile, or even undigested food to reflux back up into the esophagus from the stomach.


Symptoms of GERD

Heartburn, or chest discomfort after eating, is the most frequent symptom of GERD, which is caused by persistent acid reflux. However, people can experience GERD symptoms in a variety of different ways. Additional symptoms of GERD may include the following:

  • Chest Pain

  • Regurgitation

  • Bloating

  • Adult Onset Asthma

  • Chronic Cough

  • Hoarseness

  • Clearing of the Throat

  • Globus (knot in the throat)

  • Tooth Enamel Decay

  • Sleep Disruption

  • Dysphagia (difficulty swallowing)

Complications of GERD

Gastroesophageal Reflux Disease, often known as chronic acid reflux, is a condition that can result in potentially significant problems if it is not addressed. When left untreated, GERD can contribute to a number of other problems, including the following:

  • Esophagitis: inflammation, irritation and swelling of the esophagus

  • Stricture: chronic esophagitis causes scarring and narrowing of the esophagus

  • Barrett’s Esophagus: pre-cancerous changes of the esophagus due to chronic reflux

  • Esophageal Cancer

  • Pneumonia

  • Pulmonary Fibrosis

treatment of GERD

If you’ve been diagnosed with GERD, you’ve likely sat down with your doctor to explore treatment options. GERD patients have a variety of treatment choices, ranging from simple lifestyle modifications to drugs and, in many cases, surgery. The weakness of the lower esophageal sphincter, which is one of the leading causes of GERD, is one of the largest problems with the treatment strategies of many individuals. Medication-based treatments, such as the usage of proton pump inhibitors (PPIs) and over-the-counter antacids, are a band-aid approach that may temporarily alleviate symptoms, but are not designed for long-term use and can lead to major side effects. In patients who have symptoms despite low dose or intermittent medications, anti-reflux procedures and surgeries should be explored and considered to treat the underlying cause of the patient’s GERD, preventing any further damage and eliminating the need for medications.

Robotic fundoplications, the LINX reflux management system, and the endoscopic transoral incisionless fundoplication (TIF/EsophyX®) technique are three cutting-edge anti-reflux surgical methods that Dr. Grandhige has refined in order to provide long-term solutions for his patients who are struggling with persistent acid reflux (GERD) and Laryngopharyngeal reflux. He is the only board-certified surgeon in the Tampa Bay area that performs all three of these procedures with regularity. He has devoted over a decade to the process of developing individualized treatment strategies for each of his patients that are based on the particular conditions of their case and the requirements they have. He has performed over 600 fundoplications, over 600 LINX procedures and over 200 TIF procedures.

Surgical Treatment options for GERD


The Fundoplication is an outpatient surgical operation performed robotically or laparoscopically aimed to prevent acid reflux by reinforcing a weak lower esophageal sphincter with the patient’s stomach, creating a lower esophageal acid barrier.

LINX Reflux Management System

The LINX® System is an outpatient procedure that consists of a thin, flexible band of magnetic beads encased in titanium that is inserted robotically or laparoscopically around the lower esophageal sphincter. The magnetic attraction between the beads increases the opening pressure of the LES, assisting a weak sphincter complex preventing reflux.

TIF (EsophyX®)

Transoral Incisionless Fundoplication is the most successful endoscopic, incision-free procedure used to reconstruct, a weak lower esophageal sphincter technique that offers patients a method of anatomically strengthening their weak sphincter minimize the occurrence of acid reflux.

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