GERD and Acid Reflux Treatment in Katy, TX
Care for heartburn and reflux that keeps coming back, with testing when you need it and a plan that goes beyond another bottle of antacids.
Understanding GERD and Acid Reflux
Gastroesophageal reflux disease (GERD) happens when stomach contents flow back up into the esophagus, the tube that carries food from your mouth to your stomach. Occasional heartburn after a large meal is common. When reflux happens often, causes troublesome symptoms, or starts to damage the esophagus, it is called GERD. It is one of the most common digestive conditions in the United States.
Normally, a ring of muscle at the bottom of the esophagus, the lower esophageal sphincter, opens to let food into the stomach and then closes. In GERD, this valve relaxes too often or does not close well, so acid and other stomach contents wash back up and irritate the lining of the esophagus.
Symptoms of GERD
- Heartburn, a burning feeling behind the breastbone, often after meals or when lying down
- Regurgitation, a sour or bitter taste as food or liquid comes back up
- Chest pain
- Difficulty swallowing, or a feeling that food is sticking
- A chronic cough, hoarseness or frequent throat clearing
- Asthma that is hard to control, especially at night
- Damage to tooth enamel
Not everyone with GERD has heartburn. Some people mainly notice a cough, a hoarse voice or a sore throat.
Chest pain should always be checked by a doctor first to rule out a heart problem. Call 911 for chest pain with shortness of breath, sweating, or pain spreading to the arm, jaw or back.
What causes GERD?
GERD usually develops from a combination of factors that weaken the barrier between the stomach and the esophagus or increase pressure on the stomach:
- A hiatal hernia, when part of the stomach pushes up through the diaphragm into the chest
- Excess weight, especially around the waist, which presses on the stomach
- Pregnancy
- Smoking, which weakens the lower esophageal sphincter
- Large or late meals, and lying down soon after eating
- Some medicines, including certain blood pressure medicines, sedatives and some asthma medicines. Pain relievers such as ibuprofen and naproxen can also irritate the esophagus.
- Food and drink triggers that vary from person to person, such as fatty or spicy meals, chocolate, coffee, alcohol and citrus
Possible complications
Over time, untreated reflux can lead to:
- Esophagitis, inflammation and sores in the lining of the esophagus
- Strictures, narrowing of the esophagus that makes swallowing difficult
- Barrett’s esophagus, a change in the lining of the esophagus that raises the risk of esophageal cancer. Barrett’s esophagus does not cause symptoms of its own and is found on an upper endoscopy.
When to see a gastroenterologist
See a specialist if you have heartburn or regurgitation more than twice a week, if you have needed reflux medicine for more than a few weeks, or if your symptoms come back as soon as you stop it. See a doctor promptly if you notice:
- Difficulty or pain when swallowing, or food getting stuck
- Weight loss you cannot explain
- Vomiting that keeps returning, or vomit that contains blood or looks like coffee grounds
- Black, tarry stools
- Anemia on a blood test
Our approach to GERD and Acid Reflux
Reflux treatment is not one size fits all. Our gastroenterologists start by confirming that your symptoms really are caused by reflux, then match treatment to how severe it is and how it affects your life. The goal is lasting relief on the least medicine you need.
Getting the diagnosis right
Many people with typical heartburn and no warning signs can start with a short course of treatment. If symptoms do not settle, or if there are warning signs, we look more closely:
- An upper endoscopy (EGD) to look for inflammation, strictures, a hiatal hernia or Barrett’s esophagus, and to take biopsies if needed. It also checks for conditions that can mimic reflux, such as eosinophilic esophagitis.
- Esophageal pH monitoring, which measures how often acid reaches the esophagus over 24 to 96 hours. This is the most reliable way to confirm reflux when an endoscopy looks normal. We arrange this test through a trusted partner, as it is not performed in our office.
- Esophageal manometry, which measures how the esophagus squeezes, usually before reflux surgery or when swallowing is difficult.
Upper endoscopies are performed by our own physicians at Zazen Surgery Center, in the same building as our clinic.
Treatment options
- Daily habits. Losing excess weight, stopping smoking, raising the head of your bed if symptoms are worse at night, and avoiding meals for two to three hours before lying down all reduce reflux. Our registered dietitians can help you identify your own food triggers without cutting out more than you need to.
- Medicines. Options range from antacids and alginates for occasional symptoms, to H2 blockers, to proton pump inhibitors (PPIs) such as omeprazole for frequent symptoms or esophagitis. A newer type of acid blocker, vonoprazan, is FDA approved for adults with erosive esophagitis or reflux heartburn and is an option for some patients. PPIs work best taken 30 to 60 minutes before a meal, a detail that is often missed.
- The right dose for the long term. When symptoms are under control, we look at whether your dose can be lowered or stopped, and we continue treatment when you need it, for example if you have severe esophagitis or Barrett’s esophagus.
- Procedures and surgery. For people whose reflux is confirmed by testing and either does not respond well to medicine or who prefer not to take medicine long term, options include anti-reflux surgery and other procedures that strengthen the valve. We help you decide whether you are a good candidate and work with experienced surgeons.
Barrett’s esophagus screening and follow-up
People with long-standing reflux who also have three or more risk factors, such as being male, over 50, White, a current or former smoker, carrying excess weight around the waist, or having a parent, sibling or child with Barrett’s esophagus or esophageal cancer, may benefit from a screening endoscopy. If Barrett’s esophagus is found, we follow it with regular endoscopies to look for precancerous changes as early as possible.
Many people take reflux medicine for years without anyone checking whether it is the right treatment, at the right dose, taken the right way. A careful review can help, and sometimes that means less medicine, not more.
Dr. Vivian Asamoah, MD
Board-Certified Gastroenterologist, Integrative Medicine
Key Facts
What you need to know
Everything you need to know before your appointment.
Who should consider this
Anyone with frequent heartburn or reflux, or symptoms that return as soon as medicine stops.
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What to expect
A detailed first visit, a review of your current medicine, and testing only when it will change your care.
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Recovery and results
Many people notice improvement within a few weeks of the right changes and treatment.
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Why our team
Gastroenterologists who diagnose, test and treat reflux, with upper endoscopy in the same building.
Learn moreWhat Our Patients Say
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Dr. Asamoah is a wonderful doctor with an excellent bedside manner who cares about what you're going through and leaves no stone unturned I highly recommend.
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From the moment of entering the Surgical Center, I felt like I was an individual and my needs were of concern. The actual procedure experience was great. Dr. Asamoah has a way of making you feel at ease. She's gathered a staff of people who do the same thing. Highly recommend.
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I was very impressed with both doctors' expression of authentic interest in and concern with my health concerns. A rare experience.
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Highly recommend. The office staff and Dr. Asamoah were helpful, friendly and very accommodating! We left feeling like we have answers and are hopeful.
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First time visit. Impressed by the clean and nice environment. Friendly staff. Doctor takes her time to hear you and answer any questions you have. Great experience.
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Wow!!! Absolutely amazed by the facility and doctor! Dr. Vivian Asamoah is extremely educational, professional, and so sweet! I went in feeling extremely anxious because of my health issues, and she put me at ease by explaining every detail! Xiomara, her MA, was so helpful and thorough. Honestly, she is by far one of the best doctors I've seen. God bless this office and everyone in it! I most definitely recommend her!
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I went in to check on issues I was having with my colon. I was in a panic and was not feeling my best. Dr. Asamoah was kind and very understanding, with great patient-relationship skills. She is genuine and truly professional. Her staff is great and wonderful. I will recommend my family and friends.
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Had a great experience. The doctors are very understanding and comforting. They listen to all of your needs. Loved their music. Very relaxing.
Individual results vary.
Ready to talk with a specialist about your reflux?
Schedule a consultation with our team. We are here to help you find lasting relief.
Expert GI. Whole-person care. All under one roof.Common questions about GERD and Acid Reflux
Acid reflux is the backward flow of stomach contents into the esophagus. Heartburn is the burning feeling it often causes. GERD is the diagnosis when reflux happens often, causes troublesome symptoms or damages the esophagus.
GERD is very common and usually well controlled with treatment. Left untreated for years, it can lead to esophagitis, narrowing of the esophagus, or Barrett's esophagus, which raises the risk of esophageal cancer. That is why frequent or long-standing reflux should be evaluated.
Common triggers include fatty or fried meals, spicy food, chocolate, coffee, alcohol, carbonated drinks, citrus, tomatoes, onions and peppermint. Triggers differ from person to person, so it is better to find yours than to cut out everything. Meal size and timing matter as much as what you eat.
Yes. Reflux can cause chest pain, a chronic cough, hoarseness and throat clearing. Chest pain should always be checked first to rule out a heart problem, and a cough or hoarseness has other possible causes, so testing helps confirm whether reflux is responsible.
Not always. An upper endoscopy is recommended if you have difficulty swallowing, weight loss, bleeding, vomiting or anemia, if symptoms do not respond to treatment, or if you have long-standing reflux with risk factors for Barrett's esophagus.
For people who need them, PPIs are generally safe and effective. Some studies have linked long-term use to other health problems, but most of these links have not been shown to be caused by PPIs. The best approach is to use the lowest dose that controls your symptoms and review the need regularly with your doctor.
For some people, reflux goes away with weight loss and lifestyle changes. Others need ongoing treatment to control it. Anti-reflux surgery or procedures can provide long-term relief for selected patients whose reflux is confirmed by testing.
Barrett's esophagus is a change in the lining of the lower esophagus, usually caused by long-standing reflux. It raises the risk of esophageal cancer, although most people with Barrett's never develop cancer. It is found and monitored with upper endoscopy.
Heartburn is very common in pregnancy because of hormone changes and pressure from the growing baby. Smaller meals and not lying down after eating often help. Talk with your obstetrician or gastroenterologist before taking any medicine.
Surgery or another anti-reflux procedure may be an option when reflux is confirmed by testing and is not well controlled with medicine, when regurgitation is the main problem, or when someone prefers not to take medicine long term. Tests such as pH monitoring and esophageal manometry are done first.
Houston Gastro Institute diagnoses and treats GERD, acid reflux and Barrett's esophagus at our clinic on Kingsland Boulevard in Katy, TX. Patients come to us from across west Houston, including Cinco Ranch, Fulshear, Richmond, Brookshire, Sugar Land and Cypress. Upper endoscopies are performed at Zazen Surgery Center in the same building.