Treatment Programs

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Swallowing and Heartburn Center

The Swallowing and Heartburn Center at the Massachusetts General Hospital Digestive Healthcare Center provides both primary treatment and second opinion evaluations for throat, esophagus and stomach disorders.

A Multidisciplinary Approach to Care

The Swallowing and Heartburn Center brings together a team of gastroesophageal specialists who provide expert diagnosis, cutting-edge medical and surgical interventions and ongoing care for throat, esophagus and stomach disorders.

Working closely with both the patient and the referring physician, this multidisciplinary team works together seamlessly to develop a personalized treatment strategy for each patient and includes:

  • Gastroenterologists
  • Surgeons with special expertise treating benign and malignant gastroesophageal conditions
  • Diagnostic and interventional radiologists
  • Medical oncologists
  • Radiation oncologists
  • Nurse practitioners and oncology nurses
  • Nutritionists
  • Speech and language pathologists

Coordinated Care for Gastroesophageal Disorders

Our board-certified digestive health specialists work together to help patients diminish episodes of discomfort through diagnosis and treatment options, including a combination of medication, lifestyle changes, endoscopic therapies and, when appropriate, surgical procedures.

The Swallowing and Heartburn Center works collaboratively with surgeons in Massachusetts General Hospital’s Gastroesophageal Surgery Program to provide comprehensive, personalized treatment for patients with gastroesophageal conditions. Our surgeons specialize in complex surgical techniques, such as magnetic sphincter augmentation (LINX procedure) for the treatment of gastroesophageal reflux disease (GERD) and endoscopic myotomy (POEM) for the treatment of achalasia. Learn more about this program

Leaders in the Medical Management of GI Motility Disorders and Surgical Treatment of GERD and Hiatal Hernias

We are a leading resource for patients who have had previously unsuccessful antireflux operations.

We are also a leading center for the development of new therapeutic approaches, such as natural orifice transluminal endoscopic surgery (NOTES), in which surgery is performed without the need for incisions. Learn more about NOTES

LINX® Reflux Management System

new treatment for gerd

An innovative procedure using magnets offers a less invasive treatment for gastroesophageal reflux disease (GERD). Learn more about the LINX® Reflux Management System

We specialize in the surgical treatment of GERD (gastroesophageal reflux disease) and hiatal hernias. Read a news article

As high-volume surgeons, we have achieved excellent results in repairing hiatal hernias and relieving patients of GERD symptoms. Nearly 75 percent of patients undergoing surgery can discontinue acid suppressive medications and more than 90 percent of patients undergoing surgery at Mass General expressed a high degree of satisfaction with their outcomes. [Source: D.W. Gee et al. (2008). Measuring the Effectiveness of Laparoscopic Nissen Fundoplication: Long Term Results. Archives of Surgery 43, 482–487.]

Other surgical interventions include:

  • Esophagectomy, surgical removal of the esophagus
  • Gastrectomy, surgical removal of the stomach in patients with stomach cancer
  • D 2 node dissection, a more complete surgical sample of the lymph nodes used to ensure thorough diagnosis of gastric cancer

Learn more about these procedures in the Department of Surgery

Laparoscopic Procedures and Other Minimally Invasive Options Minimally invasive treatments are often options for patients who would have required traditional open surgery in the past. These new techniques have the benefit of faster recovery times, smaller surgical scars and greater nerve preservation. Minimally invasive options include:

  • Laparoscopic antireflux surgery: We were one of the first hospitals in New England to perform this procedure and continue to be a leading source today
  • Laparoscopic heller myotomies: We have performed some of the highest volumes of this procedure in New England to treat achalasia
  • Laparoscopic procedures to treat cancers of the esophagus, stomach and gastroesophageal junction: We are one of the few hospitals in the world to offer these minimally invasive procedures

Minimally Invasive Ablation Procedures

Surgery may not be an option for all patients or conditions. For those patients for whom surgery is not possible, minimally invasive ablation procedures include:

  • Radiofrequency ablation, a novel method offered by few centers in New England, used to treat Barrett’s esophagus
  • Photodynamic therapy, a laser procedure used on precancerous areas or to destroy lesions caused by Barrett’s esophagus
  • Endoscopic mucosal resection, an endoscopic means of removing small cancers from the stomach and esophagus that does not require surgery

One Call Coordinates CareWe provide patients and referring physicians with an experienced access coordinator, a clinician who is available to assess patients’ needs, coordinate appointments and begin the appropriate testing regimen. Contact the Swallowing and Heartburn Center’s access coordinator and we will call you back within two business days.

We are a leading referral center in New England for the treatment of achalasia, a common swallowing problem, and provide treatment and ongoing care for the full range of gastroesophageal and swallowing conditions, including:

A Dedicated Referral Line for Physicians and PatientsWe provide patients and referring physicians with an experienced access coordinator, a clinician who helps assess patient needs, coordinate appointments and begin the appropriate testing regimen. Contact the Swallowing and Heartburn Center’s access coordinator

Calls will be returned within 24 hours.

Advanced Diagnostic Motility Evaluation ServicesThe Digestive Healthcare Center is the one of few centers in the Eastern United States currently offering gastroduodenal manometry and Smartpill technology, which detects conditions related to nonfunctioning stomach muscles, including gastroparesis and GI motility disorders of the small bowel and colon.

Advanced Endoscopic Diagnosis and Treatment

We offer inpatients a quick turnaround and highly specialized, expert analysis of their test findings, 24 hours a day, for a range of diagnostic and therapeutic procedures. Our endoscopists are available around the clock to confer with referring physicians. Diagnostic services include:

  • Endoscopic ultrasound, which creates an image of the esophagus using sound waves
  • High-resolution manometry, which measures pressure within the gastrointestinal tract using special sensors
  • Esophageal motility test, which measures the esophagus’s ability to move
  • pH probe testing, used to diagnose gastroesophageal reflux
  • Wireless Bravo pH testing
  • Impedance/pH testing to determine if stomach contents are coming up into the esophagus

Our diagnostic radiology team comprises dedicated imaging specialists whose practice focuses specifically on GI scans. They are nationally recognized for expertise in all forms of sophisticated imaging and offer a full range of advanced diagnostic techniques, including:

  • Fiber optic evaluations, which measures a patient’s ability to swallow
  • Video-fluoroscopic swallowing studies, which captures video X-rays after the patient has taken barium
  • Barium esophagrams, which captures images after the patient has taken barium, an element that helps with X-ray imaging
  • Speech pathology assessments to identifies speech and language deficits

Referring physicians can request these diagnostic studies by contacting the Swallowing and Heartburn Center’s access coordinator.

Clinical Research Studies & TrialsOur physicians are active in clinical trials and research studies related to gastroesophageal and swallowing disorders, allowing us to bring our patients promising new treatments as quickly as possible.

Our surgeons have helped evaluate first generation endoluminal therapies, such as the NDO Plicator and the Bard EndoCinch Suturing System, involving minimally invasive surgeries performed through the esophagus. We are currently evaluating newer developments in this area such as the Esophyx Totally Intraluminal Fundoplication.

We also published a landmark study demonstrating that not all patients with paraesophageal hernias would benefit from surgery. [Source: N. Stylopoulos et al. (2002). Paraesophageal Hernias: Operation or Observation. Annals of Surgery 236, 492–501.]

Current pioneering research efforts include:

  • A Medigus trial to study the safety and effectiveness of the Medigus SRS Endoscopic Stapling System in gastroesophageal reflux disease (GERD)
  • Clinical trials of less invasive treatments for gastroesophageal reflux
  • Clinical trials related to the neoadjuvant treatment of gastric and esophageal cancers through the Cancer Center
  • The use of natural orifice surgery to remove diseased organs without making incisions in the body wall
  • The treatment of gastrointestinal stromal tumors (GIST) by combined endoscopic and laparoscopic methods

Patients interested in participating in clinical trials can browse online for open trials.

Barrett's Esophagus

Barrett's esophagus is a condition in which normal cells that line the esophagus turn into cells not usually found in humans called “specialized columnar cells.”

Esophageal Cancer

Esophageal cancer is cancer that develops in the esophagus, the muscular tube that connects the throat to the stomach.

Gastroesophageal Reflux Disease (GERD) / Heartburn

Gastroesophageal reflux disease (GERD) is a digestive disorder that is caused by gastric acid flowing from the stomach into the esophagus.

Gastroparesis

Gastroparesis is a stomach disorder in which the stomach takes too long in emptying its contents.

Halitosis (Bad Breath)

Halitosis is an oral health condition characterized by consistently odorous breath.

Helicobacter Pylori

H. pylori is a spiral-shaped bacterium found in the stomach, which (along with acid secretion) damages stomach and duodenal tissue, causing inflammation and peptic ulcers.

Hiatal Hernia

A hiatal hernia occurs when the upper part of the stomach pushes up into the chest through a small opening in the diaphragm, the muscle that separates the stomach from the chest.

Indigestion

Indigestion, also known as dyspepsia, is a painful or burning feeling in the upper abdomen and is usually accompanied by nausea, bloating or gas, a feeling of fullness, and, sometimes, vomiting.

Stomach and Duodenal Ulcers (Peptic Ulcers)

An ulcer is an open sore, or lesion, usually found on the skin or mucous membrane areas of the body.

Stomach Cancer

Stomach cancer, also known as gastric cancer, is cancer that starts in any part of the stomach.

The following related clinical trials and research studies are currently seeking participants at Massachusetts General Hospital. Search for clinical trials and studies in another area of interest.

Relief from GERD, once and for all

Finally, good news for patients who have chosen not to have surgery to treat their gastroesophageal reflux disease (GERD) because they doubted surgery’s effectiveness. A new study reveals the benefits of a simple procedure that can vastly improve their quality of life. And, even better, the relief offered by this surgery is lasting and doesn’t require the hassle and expense of taking proton pump inhibitors (PPIs) and other prescription and over-the-counter drugs.

Massachusetts General Hospital offers new, less invasive treatment for GERD

Massachusetts General Hospital introduces an innovative procedure for patients experiencing symptoms of GERD. A bracelet of magnetic beads can help the lower esophageal sphincter to resist gastric pressures and prevent reflux.

Frequently asked questions: LINX® system

David Rattner, MD, chief of the Division of Gastrointestinal and General Surgery at the Mass General Digestive Healthcare Center, answers frequently asked questions (FAQ) about the LINX® Reflux Management System, a new treatment option for gastroesophageal reflux disease (GERD).

Three months after surgery, patient has new lease on life

The MGH was the first hospital in New England to offer a new procedure in which a flexible bracelet of magnetic titanium beads is laparoscopically implanted around the esophagus to help treat GERD.

Magnetic esophageal sphincter device benefits patients with GERD

The New England Journal of Medicine publishes the three-year results of a study of the safety and effectiveness of a new device for treatment of gastroesophageal reflux disease (GERD).

Pill-sized capsule could revolutionize cancer screening

A new capsule-like device may provide an alternative screening method for Barrett’s esophagus and esophageal cancer.

New procedure is easy to swallow

The MGH offers its first per-oral endoscopic myotomy (POEM) procedure, a new surgical treatment for achalasia.

On-Demand CME Program

Confronting the Epidemic of Esophageal Cancer: Innovative Screening Techniques and Treatment Strategies for Barrett's Esophagus and GERD

Preview clip of Digestive Healthcare Center CME program

David Ryan, MD, explains the reasons for the current epidemic of esophageal cancer.

Preview clip of Digestive Healthcare Center CME program

David Rattner, MD, explains the management of gastroesophageal reflux, including indications for medical, endoscopy and surgical interventions to control this condition.

Preview clip of Digestive Healthcare Center CME program

Christopher Morse, MD, reviews minimally invasive treatments for esophageal cancer, including esophageal resections. Please note that this video contains images from a real procedure and may cause discomfort for some viewers.

David Rattner, MD, explains how screenings can prevent esophageal cancer

David Rattner, MD, Co-Chief of the Massachusetts General Hospital Digestive Healthcare Center describes how chronic heartburn can lead to other serious conditions, who is most at risk and how Barrett's esophagus and esophageal cancer can be diagnosed and treated.

Endoscopic Mucosal Resection

Endoscopic mucosal resection (EMR) is a specialized endoscopic technique used by gastroenterologists at the Massachusetts General Hospital Digestive Healthcare Center to diagnose and remove large areas of early gastrointestinal cancers.

Radiofrequency Ablation Treatment

Radiofrequency ablation (RFA) is an FDA-approved endoscopic technique used by specialists at the Massachusetts General Hospital Barrett's Esophagus Treatment Center to treat Barrett's esophagus.

LINX® Reflux Management System

LINX® Reflux Management System is an innovative minimally invasive procedure used by Massachusetts General Hospital surgeons to treat appropriately selected patients experiencing symptoms of gastroesophageal reflux disease (GERD). For more information, visit massgeneral.org/LINX

Swallowing and Heartburn Center

Blake 4
55 Fruit Street
Boston, MA 02114

Phone: 617-724-6038
Hours: 8:00 am to 5:00 pm, Monday through Friday


To begin the appointment process, contact the Swallowing and Heartburn Center access coordinator at 617-724-6038 or request an appointment online.

Next Steps:

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Our approach to patient care brings together a team of digestive health specialists who create a personalized treatment plan for each patient.