Upper Endoscopy GERD/Reflux Procedures in Baltimore, Maryland

It is performed to diagnose the causes of pain, bleeding or blockage of the upper GI system, and it allows the option of removal of small benign tumors and tissue biopsy. Newer techniques and instruments allow physicians to alter the width of the intestinal tube in cases of narrowing due to scar tissue or reduction of the size of the lumen or stoma, as is the case with bariatric surgery.

Serving cities such as Frederick and Columbia and the counties of Anne Arundel, Maryland, and Lancaster, PA gastroenterology specialists Dr. Averbach, Dr. Hamdallah, and Dr. Swift are highly trained in the use of endoscopic technology. Please request an appointment online with Dr. Averbach or Dr. Hamdallah or call their office at 667-234-8725.

Another procedure designed to repair the valve mechanism is called a Transoral Incisionless Fundoplication, or TIF, and is sometimes combined with a hiatal hernia repair if the hernia is greater than 2 cm in length.  This procedure consists of an endoscopy where a camera is passed down the throat. A device attached to the endoscope is then used to fold the top portion of the stomach over the bottom of the esophagus to recreate the valve. The rates of reflux resolution are similar to those seen with more traditional fundoplication methods.

• You have significant reflux that is not responsive to medication therapy
• Have a small to medium-sized hiatal hernia
• Have a desire to stop taking your antireflux medication

• Low mortality rate
• If no hiatal hernia is present, then the entire procedure is incisionless, which translates to less downtime and less pain
• Ability to fix hiatal hernia at the same time if one is present
• Folded over valve is more physiologically similar to the original valve
• High rates of reflux remission
• Lower rates of gas bloat, dysphagia, and flatulence

• Not able to be performed on patients who have had previous bariatric surgery
• Possibility of recurrence
• Foods that you eat now may cause discomfort, nausea, or vomiting after your surgery
• Requires adherence to dietary recommendations and follow-up compliance
• Only suitable for patients with a BMI less than 40
• A newer procedure, so fewer data available on long-term outcomes

Stretta is an entirely endoscopic procedure designed to increase the strength and size of the valve between the stomach and the esophagus. In this procedure, radiofrequency waves are sent into the tissue surrounding the valve, which causes muscle growth over time.  This enables the valve to close more effectively.  Improvements are seen gradually in the four months after the procedure, and about 84% of patients are able to stop their reflux medication completely.  Since this procedure is done entirely with a camera and flexible scope placed down the throat, no incisions are needed translating to less pain, and shorter downtime, in addition to no overnight hospital stay.

• You have significant reflux that is not responsive to medication therapy
• Have a hiatal hernia less than 2cm in length
• Have a desire to stop taking your antireflux medication

• Low mortality rate
• Able to be performed on patients who have had previous bariatric surgery, regardless of the procedure
• The entire procedure is incisionless, which translates to less downtime and less pain
• High rates of reflux remission
• Done as an outpatient procedure
• Ability to do multiple treatments if necessary

A thin scope with a light and camera at its tip is used to look inside the upper digestive tract — the esophagus, stomach, and first part of the small intestine, called the duodenum.

Usually performed as an outpatient procedure, upper endoscopy sometimes must be performed in the hospital or emergency room to both identify and treat conditions such as upper digestive system bleeding.

The procedure is commonly used to help identify the causes of:

• Abdominal or chest pain
• Nausea and vomiting
• Heartburn
• Bleeding
• Swallowing problems

Endoscopy can also help identify inflammation, ulcers, and tumors.

Upper endoscopy in Baltimore, Maryland is more accurate than X-rays for detecting abnormal growths such as cancer and for examining the inside of the upper digestive system. In addition, abnormalities can be treated through the endoscope. For example:

• Polyps (growths of tissue in the stomach) can be identified and removed, and tissue samples (biopsies) can be taken for analysis.
• Narrowed areas or strictures of the esophagus, stomach, or duodenum from cancer or other diseases can be dilated or stretched using balloons or other devices. In some cases, a stent (a wire or plastic mesh tube) can be put in the stricture to prop it open.
• Objects stuck in the esophagus can be removed.
• Bleeding due to ulcers, cancer or varices can be treated.

Before an upper endoscopy in Baltimore, Maryland tell your doctor if you are pregnant, have alung or heart condition, or if you are allergic to any medications.

Also, tell your doctor if you have:

• Ever been told you need to take antibiotics before a dental or surgical procedure
• Ever had endocarditis (an infection of the heart valves)
• An artificial heart valve
• Rheumatic heart disease

If you have any of these conditions or devices, you may need to take antibiotics before the upper endoscopy.

Do not eat or drink anything for eight hours before the procedure.

Medications for high blood pressure, heart conditions, or thyroid conditions may be taken with a small sip of water before the procedure. If you have diabetes and use insulin, you must adjust the dosage of insulin the day of the test. Your diabetes care provider will help you with this adjustment. Bring your diabetes medication with you to your appointment so you can take it after the procedure.

Make arrangements to have someone drive you home following the endoscopy. The sedation given during the procedure causes drowsiness and dizziness and impairs your judgment, making it unsafe for you to drive or operate machinery for up to eight hours following the procedure.

There is a small chance of a hole (perforation) in the stomach, duodenum, or esophagus from the scope moving through these areas. There is also a small risk of bleeding at the biopsy site.

You could have a reaction to the medicine used during the procedure, which could cause:

• Apnea (not breathing)
• Difficulty breathing (respiratory depression)
• Excessive sweating
• Low blood pressure (hypotension)
• Slow heartbeat (bradycardia)
• Spasm of the larynx (laryngospasm)