Gastroenterology in Palmdale, California

Gastroenterologists at Palmdale Regional Medical Center diagnose and treat diseases of the stomach, intestines and related organs, including the esophagus, stomach, liver and pancreas. These physicians are highly trained and educated on biliary tract disease (gall stones), pancreatic diseases and inflammatory bowel disease (ulcerative colitis and Crohn’s disease).

Gastroesophageal Reflux Disease

Gastroesophageal Reflux Disease (GERD), also known as Acid Reflux Disease, affects millions of Americans. GERD occurs when stomach acids or intestinal bile leak back from the stomach into the esophagus (the tube that runs from the mouth to the stomach), a process called gastroesophageal reflux. Reflux can irritate the esophagus, cause heartburn and other symptoms, and can damage the esophagus.

When people eat, food passes from the throat to the stomach through the esophagus. After food has passed into the stomach, a ring of muscle fibers called the lower esophageal sphincter, or LES, prevents food from moving backward into the esophagus. If this sphincter muscle doesn't close completely, food, liquid and stomach acid can leak back into the esophagus. This is called reflux or gastroesophageal reflux. Reflux may cause symptoms, or it can even damage the esophagus.

Heartburn is the most common symptom, but other symptoms may include:

• Regurgitation
• Hoarseness
• Belching
• Sore throat
• Asthma-like symptoms
• Chest pain or discomfort
• Excessive throat clearing
• Persistent cough
• Bloating
• Burning in the mouth or throat

Complete a brief self-assessment to see if you might benefit from GERD therapeutic intervention >

Hiatal Hernia

Having a hiatal hernia is common in people who have GERD. A hiatal hernia occurs when part of the stomach moves up into the chest cavity. The diaphragm separates the chest cavity from the abdominal cavity, and a natural hold in the diaphragm is where the esophagus passes from the chest to the abdomen. However, when ligaments holding the esophagus become too loose, the hole becomes too large, which then allows the stomach to partially move into the chest cavity.

A hiatal hernia aggravates reflux symptoms because when the stomach moves up, it is difficult to maintain adequate pressure in the stomach, contributing to the gastroesophageal valve (GEV) not closing completely. This breaks down the high-pressure zone and can contribute to GERD symptoms, especially when lying down.

Treatment Options

Medication, diet and lifestyle changes are the most common treatment options for GERD. While these treatments can alleviate symptoms, they typically do not solve the problem or halt progression of disease. Even with medications, you may still need to restrict your diet.

Transoral Incisionless Fundoplication (TIF®)

Surgery may be an option to treat severe GERD. Transoral Incisionless Fundoplication (TIF®) is a surgical procedure that offers relief from acid reflux without surgical incisions by using robotic-assisted equipment and is available at Palmdale Regional Medical Center.

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Hiatal Hernia and the TIF procedure

As most patients who have GERD also have a hiatal hernia, repairing the hiatal hernia and having the TIF procedure are often done at the same time. At Palmdale Regional Medical Center, Emery L. Chen, MD, performs the hiatal hernia operation and then Jatinder Pruthi, MD, performs the TIF procedure in the same operation.

Under general anesthesia, minimally invasive laparoscopic techniques are used to access the underside of the diaphragm. The ligaments are repaired with stitches and/or mesh. Suction is used to help the surgeon move the GEV below the diaphragm while it's being repaired. The TIF procedure is then performed with an endoscope after the sliding hiatal hernia is repaired.

Benefits of having the combined procedure include:

• Being put under anesthesia only once
• Length of stay in the hospital is typically unchanged, with patients returning home the same day of the procedure
• Recovery time for both procedures is the same as having only the TIF procedure

Endoscopy Center

Endoscopy is a medical technique in which physicians use a device called an endoscope inside the body and inside hollow organs. Endoscopes consist of a rigid or flexible tube with a lens at one end that transmits images to a computer or video monitor.

Palmdale Regional has a full endoscopy unit where physicians use advanced endoscopic technology to help diagnose and treat disorders of the intestinal tract.

Barrett's Esophagus

Barrett’s esophagus occurs when cells in the lower esophagus are affected by chronic exposure to acid. Because of its strong association with esophageal cancer, Barrett’s esophagus is considered a pre-cancerous disease. Palmdale Regional Medical Center is pleased to offer the Barrx™ radiofrequency ablation system, a treatment that removes precancerous tissue (dysplastic Barrett’s esophagus) in patients with Barrett’s esophagus.

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