Heartburn and acid reflux treatment in Richmond

The Heartburn and Reflux Center of Richmond

Healthgrades five-star recipient

Stomach/Esophageal Surgeries Five-Star Recipient - Healthgrades 2021

Named a five-star recipient for Esophageal and Stomach Surgeries by Healthgrades™, we are proud to provide our community with award-winning surgical care in the heart of Richmond

If you have heartburn, nausea and other symptoms of GERD or acid reflux, contact us today at (804) 545-7987 to schedule an appointment with one of our specialists.

Gastroesophageal reflux disease (GERD)

GERD is the result of a weak muscle within the esophagus, called the lower esophageal sphincter, which acts as a reflux barrier within the body. When functioning correctly, the barrier acts as a one-way valve that allows food to flow into the stomach and prevents stomach contents from flowing back up into the esophagus. However, people who experience GERD have a barrier that does not function properly, allowing acid and bile to flow back into the esophagus.

For some people, GERD poses a serious medical problem. Severe cases of GERD can lead to esophagitis, Barrett’s esophagus, strictures and esophageal cancer.

Risk factors for GERD may include:

  • Being overweight
  • Performing jobs that require stooping, bending or heavy lifting
  • Being 40 years old or older
  • Pregnancy
  • Diabetes
  • Smoking
  • Diet
  • Certain lifestyle choices, including a diet of alcohol, citrus, caffeinated beverages, tomato-based foods, chocolate, spicy foods and peppermint

Do you have GERD?

If you answer “yes” to two or more of the following questions, you may be have GERD:

  • Do you experience an uncomfortable feeling behind the breastbone that seems to be moving upward from the stomach?
  • Do you have a burning sensation in the back of your throat?
  • Do you experience a bitter acid taste in your mouth?
  • Do you often experience these problems after meals?
  • Do you experience heartburn or acid indigestion two or more times per week?
  • Do you find that antacids only provide temporary relief from your symptoms?
  • Do you take prescription medication to treat heartburn, but still have symptoms?

When heartburn is a sign of GERD

Heartburn is a common symptom that affects about 20 percent of Americans. However, it is a key symptom and indicator of GERD, especially if your heartburn:

  • Occurs twice or more a week
  • Affects your sleep
  • Persists and becomes more severe
  • Has occurred regularly for several years

Other symptoms of GERD

Aside from chronic heartburn, GERD may also manifest in other symptoms, like difficulty swallowing, shortness of breath, wheezing, chest pain, a chronic, non-productive dry cough, achalasia (failure of the lower esophageal sphincter to open when swallowing), acid reflux, asthma, dysphagia, heartburn, hiatal hernia, indigestion and regurgitation.

Why choose Henrico Doctors' Hospital for GERD treatment?

For more than 20 years, our surgeons have performed minimally invasive laparoscopic anti-reflux surgery, helping thousands of patients live more comfortable lives. We have the experience and technology to care for even the most complex GERD cases.

Henrico Doctors' Hospital was the first program to:

Diagnostic testing for GERD

Your physician may suspect GERD based on your symptoms and medical history. To more accurately diagnose your condition, we offer the following tests.

24-hour esophageal pH monitoring

This test is the best way to confirm reflux. A 24-hour pH monitoring system uses a small tube passed through the nose or mouth, down the esophagus and into the stomach. The tube remains in place for 24 hours and monitors the amount and frequency of stomach acid that backs up into the esophagus.

Placement of the catheter takes about 30 minutes, and a nurse will review the monitoring instructions with you. You can then leave and return the next day to have the tube removed. During the 24-hour test, you can swallow, talk and breathe freely.

Preparing for the test

  • Do not eat for at least eight hours before the test
  • Do not drink for at least six hours before the test
  • Do not use heartburn relief medication for at least five to seven days before the test (this includes Dexilant, Prilosec, Prevacid, Nexium and Aciphex)
  • Do not use Tagamet, Zantac, Pepcid, Carafate or antacids for at least two days before the test
  • You will be able to drive following this test

Barium swallow exam

This exam involves a series of X-rays of the esophagus, stomach and the first part of the small intestine, called the duodenum. The X-rays are taken before and after drinking a contrast material called barium, a thick, white, chalky, milkshake-like liquid. The barium coats the inside lining of your GI tract, making it more visible on the X-ray.

The barium swallow exam shows if you’re experiencing reflux. It also reveals issues such as hiatal hernias.

Preparing for the test

  • Do not eat for at least eight hours before the test
  • Do not drink for at least six hours before the test
  • You will be able to drive following this test

Esophageal manometry

This is a diagnostic procedure that can be performed right in your doctor’s office. A special tube is passed through your mouth and into the esophagus. The tube measures the pressure that the muscles in the esophagus create.

An esophageal manometry takes roughly 25-35 minutes. You may feel a temporary sore throat after the test. Lozenges or gargling with salt water may help with the pain. After the test, call your physician if you experience:

  • New or increased chest pain
  • Difficulty swallowing
  • Shortness of breath
  • Elevated temperature

Preparing for the test

  • Do not eat for at least eight hours before the test
  • Do not drink for at least six hours before the test
  • Do not take any medications on the day of the test (this includes blood pressure medication, heart medication and muscle relaxants)
  • Do not take Reglan (Metoclopramide) 48 hours before the test
  • Do not smoke for at least two hours before the test
  • Plan to arrive 30 minutes before your test
  • You will be able to drive following this test


This procedure allows doctors to closely examine the lining of the esophagus. A thin, lighted tube with a tiny camera is passed down the throat to the esophagus and stomach. This allows your doctor to see any irritation or changes to the esophagus. To better assess your condition, an ultrasound may also be performed.

Bravo study

This minimally invasive test evaluates frequent heartburn and related symptoms. A doctor will place a temporary capsule into your esophagus. Over the 48-hour test period, the capsule will measure your pH and acid production.

In addition to the above tests, a doctor may order an EGD, abdominal ultrasound, gastric emptying or HIDA scan to further diagnose your condition. Our doctors and nurses perform all esophageal manometry and 24-hour pH tests at the Motility and Pelvic Floor Center of Parham Doctors’ Hospital.

To provide your healthcare professional with more information about your condition, complete this online GERD questionnaire.

Minimally invasive outpatient treatment options

If nonsurgical methods of GERD treatment, like lifestyle modification and medication management, have not been effective, an outpatient procedure may be your best treatment option. We offer the following minimally invasive, outpatient procedures to treat GERD:

  • Barrxfor Barrett’s esophagus. Barrx is an outpatient procedure that can minimize the risk of developing esophageal cancer if a patient has Barrett’s esophagus as a result of GERD. The procedure involves the patient swallowing a thin, flexible, lighted tube called an endoscope. The endoscope transmits images of the inside of the esophagus, allowing your physician to see which areas require treatment. A Barrx ablation catheter is also inserted into the esophagus to deliver energy to the abnormal tissue. The procedure can minimize or prevent abnormal cells from developing into a cancerous condition.
  • Stretta therapy. Performing this therapy takes about an hour. It delivers radiofrequency energy to the muscle between the stomach and esophagus, which improves the muscle tissue. The result is enhanced barrier function and fewer reflux events. Stretta therapy treats the underlying problems that may cause GERD without surgery.
  • LINX® Reflux Management System. This is a minimally invasive laparoscopic procedure that implants a series of interlinked titanium beads with magnetic cores around the esophagus just above the stomach. The magnetic attraction between the beads expands the existing esophageal sphincter’s barrier function to prevent reflux. The LINX® procedure is reversible and allows patients to preserve normal physiological functions, such as belching or vomiting.
  • Heller myotomy. This is a minimally invasive surgical procedure used to treat achalasia. A surgeon cuts the muscles of the lower esophageal sphincter, allowing food and liquids to pass to the stomach.
  • Nissen fundoplication. This is a laparoscopic procedure in the abdomen that allows the doctor to directly see and operate on the stomach. This surgery uses small incisions to pass surgical tools into the abdomen to complete the surgery. Your surgeon will view the areas on a screen with images from a small camera inserted into the abdomen.
  • Transoral incisionless fundoplication (TIF). This innovative procedure rebuilds the anti-reflux valve and restores the body’s natural protection against reflux without requiring that a doctor make incisions in your abdomen. TIF is a long-lasting, safe and effective way to treat GERD with a minimal recovery time.

Meet our heartburn nurse navigator

Cathy Adams

Cathy Adams, RN, BSN, received her undergraduate degree in the field of Rehabilitation Counseling. She spent 15 years as a case manager before deciding to pursue a career in nursing. She obtained her associates degree in nursing from Piedmont Virginia Community College and most recently completed her bachelor's degree in nursing from Virginia Commonwealth University.

Cathy began her nursing career as an endoscopy nurse at Martha Jefferson Hospital in Charlottesville, VA. During her time there, she was recognized with customer service awards by patients for her compassion and caring approach to patient care. She transitioned her career to the University of Virginia where she continued to gain further experience in endoscopy. She now joins our team at Henrico Doctors' as the new nurse navigator for the Heartburn and Reflux Center of Richmond. She will guide patients through the process of evaluating and testing for reflux disease. Her passion for patient education is an asset to both patients and families to help understand the disease process and treatment options.

In her free time, Cathy enjoys spending time with her family, exercising, watching movies and traveling.

Email: Cathy.Adams@hcahealthcare.com
Phone: 833-266-GERD (4373)

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