GERD & Heartburn Care
Start feeling better with care from the VHC Heartburn Center. Your team takes time to understand your symptoms and plan treatment for acid reflux. Visit us for help whether you live in Arlington, the DC metro area or beyond.
Director Kevin Gillian, MD, brings more than 25 years of experience to our center. He trains surgeons across the country and serves as a national expert in reflux and esophageal conditions. So, you can rely on us for high-quality care.
Team Focused on Your Health
Expect complete care from specialists in:
- Gastroenterology (digestive health)
- Surgery
- Pulmonary (lung) medicine
- Ear, nose, and throat (ENT)
Let us help you improve quality of life, reduce long‑term risks from reflux, and limit problems that can come from long-term medication use. After finding the cause of your symptoms, we may recommend lifestyle changes, certain medicines, or surgery.
Symptoms of GERD & Esophageal Conditions
GERD stands for gastroesophageal reflux disease. It's related to esophageal motility, or how food moves through your food pipe. You may deal with GERD or a motility problem if you have:
- Heartburn that doesn't get better with standard medications
- Trouble swallowing or a constant lump-in-the-throat feeling
- Hoarseness or voice loss
- Asthma that worsens with reflux
- Chest pain or spasms not related to the heart
- Vomiting or regurgitation (food coming back up), especially if it causes trouble sleeping
Why Heartburn Happens
The lining of your esophagus gets irritated when stomach acid touches it for too long. A muscle at the bottom of your esophagus, called the lower esophageal sphincter (LES), normally tightens to keep acid in your stomach. If the LES stays loose, acid moves up and causes a burning feeling.
Hiatal Hernia
Some people feel more reflux when part of their stomach pushes up through the diaphragm. Doctors call this a hiatal hernia. Genetics, straining, pregnancy, long-term coughing, and weight gain can increase your risk. A hiatal hernia can make reflux worse, but you can still have reflux even without one.
Reflux that won't go away or heartburn more than twice a week is GERD. It can lead to serious health problems.
What Can Make Heartburn Worse
You may be more likely to have reflux if you also:
- Are obese
- Are pregnant
- Smoke
- Eat large meals
- Take certain medications or supplements
Your Diet’s Impact
Your diet doesn't cause GERD. But you might feel worse when you eat:
- Chocolate
- Citrus fruits
- Drinks with caffeine or alcohol
- Fatty and fried foods
- Garlic and onions
- Mint-flavored foods
- Spicy foods
- Tomatoes, including spaghetti sauce, salsa, chili and pizza
Esophageal Motility Problems
Sometimes your symptoms come from the way the muscles in your esophagus work. Your esophagus moves food to your stomach with muscle contractions. If these muscles tighten too much or not enough, you may feel pain or have trouble swallowing.
When Contractions Are Too Strong
Very strong contractions can cause chest pain or make swallowing difficult. This can happen if you have conditions like esophageal spasm, nutcracker esophagus, jackhammer esophagus, or a tight LES. Once we find the issue, we can treat it.
When Contractions Are Too Weak
Weak contractions make it hard for food to travel to the stomach. Scleroderma can weaken the esophagus over time. Achalasia happens when nerves in the esophagus stop working correctly, which leads to severe swallowing problems and food coming back up. Achalasia often looks like reflux until testing shows the difference.
Tests to Understand Your Symptoms
Our team guides you through each test and makes the process as simple and comfortable as possible. Your doctor may order one or more of the following studies.
Upper GI X-ray (UGI)
Done by Radiology
During this test, you drink a barium liquid while an X-ray machine takes images. The test shows reflux, hiatal hernias, and certain other problems in the esophagus. It also shows strictures (narrowing) or ulcers (wounds), although it may not reveal mild irritation.
Upper Endoscopy (EGD)
Done by Gastroenterology
Your care team gives you sedation to relax you and prevent pain. Then, a doctor places a small camera through your mouth into your esophagus, stomach, and the first part of your small intestine. The camera shows irritation, inflammation, or other problems. Your doctor may also take a small tissue sample, called a biopsy, to guide your treatment.
BRAVO Study
During an endoscopy, your doctor attaches a tiny capsule to the lower esophagus. The capsule measures acid levels over several days and sends the information wirelessly to a recorder you wear.
Esophageal Function Testing (EFT) or High-Resolution Impedance Manometry (HRIM)
Done at the Heartburn Center
This study measures how well the muscles in your esophagus and LES tighten and relax. Doctors use this information to diagnose swallowing problems and plan the best treatment.
24 Hour pH Impedance Study
Done at the Heartburn Center
For this study, a small wire stays in your esophagus for 24 hours and measures both acid and non‑acid reflux. Your doctor compares the readings with your symptom diary to understand how reflux episodes match what you feel. This test also shows whether reflux contributes to coughing, wheezing, or other breathing symptoms.
Surgery for GERD
In short, acid belongs in the stomach. The only way to keep the acid in the stomach and not suffer from GERD is to fix the valve between the stomach and esophagus.
Several surgeries can strengthen this valve and keep stomach acid where it belongs. You can usually go home the same day or after one night in the hospital.
Learn more about surgery at VHC Health.
Fundoplication
Surgeons perform fundoplication through small incisions, using a surgical robot or scope (tube with a light and camera). If you have a hiatal hernia, they repair it first. Then, they wrap the top of your stomach around the lower esophagus to create a stronger valve. This procedure controls reflux well, although it may make belching or vomiting more difficult.
LINX Procedure
Surgeons repair any hiatal hernia and place a small ring of magnetic beads around the LES. The magnets open when you swallow and close afterward to prevent reflux. Unlike fundoplication, LINX acts more like your normal valve, so it's easier to belch and vomit afterward. It also leads to less bloating. So, many patients choose LINX.
Heller Myotomy
Surgeons use a Heller myotomy for achalasia and some spastic disorders. They divide the tight, non‑working muscles in the lower esophagus so food can pass more easily into the stomach. This surgery usually brings major relief and improves daily life.
Want More Information?
Ask us for help to understand your options and choose the right test or treatment. Your healthcare provider must send an order for any study, and our team can guide you if you have questions.
Referring a Patient?
Download the VHC Heartburn Center referral pad [PDF].
