Swallowing and Heartburn Program
The Swallowing and Heartburn Program at the Gastroenterology Division of Massachusetts General Hospital provides both primary treatment and second opinion evaluations for disorders of the esophagus and stomach.
- Request an appointment online
A Multidisciplinary Approach to Care
The Swallowing and Heartburn Program brings together a team of gastroesophageal and motility specialists who provide expert diagnosis, cutting-edge medical and surgical interventions and ongoing care for esophagus and motility disorders.
Working closely with both the patient and the referring physician, this multidisciplinary team drawn from specialists in the Digestive Healthcare Center works together seamlessly to develop a personalized treatment strategy for each patient and includes:
- Diagnostic and interventional radiologists
- Medical oncologists
- Radiation oncologists
- Nurse practitioners and oncology nurses
- Speech and language pathologists
Coordinated Care for Gastroesophageal and Motility Disorders
Our board-certified digestive health specialists work together to help patients diminish episodes of discomfort through expert diagnosis and treatment options, including a combination of medications, lifestyle changes, endoscopic therapies and, when appropriate, surgical procedures.
Leaders in the Medical Management of Esophageal Disorders
Our gastroesophageal experts provide cutting-edge care for a variety of esophageal disorders including acid reflux disease, hiatal hernias, Barrett’s esophagus, GI motility disorders, achalasia, and eosinophilic esophagitis. Our approach utilizes a combination of medical, endoscopic, and radiologic testing to come to the correct diagnosis and develop a successful treatment plan.
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
Surgical options are also available in the treatment of GERD (gastroesophageal reflux disease). Read a news article about an innovative new procedure for treatment of GERD
Minimally Invasive Ablation Procedures
Surgery may not 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
We work closely with our surgeons and are a leading resource for patients who require esophageal surgery. 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 this procedure.
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. Offered through our colleagues in the Department of Surgery, these new techniques have the benefit of faster recovery times, smaller surgical scars and greater nerve preservation. Minimally invasive options include:
- Laparoscopic antireflux surgery
- Laparoscopic heller myotomies
- Laparoscopic procedures to treat cancers of the esophagus, stomach and gastroesophageal junction.
One Call Coordinates Care
We 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.
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About This Program
We are a leading referral center in New England for the treatment of achalasia, Barrett’s esophagus, and esosinophilic esophagitis and provide treatment and ongoing care for the full range of gastroesophageal and swallowing conditions, including:
- Barrett's esophagus: see the Barrett's Esophagus Treatment Center for more information
- Chronic cough
- Eosinophilic Esophagitis
- Esophageal cancer
- Esophageal motility disorders
- GERD (gastroesophageal reflux disease) that has not responded to oral medication such as proton pump inhibitors
- Hiatal hernia
- Laryngo-pharyngeal reflux disease (LPR)
- Noncardiac chest pain
- Premalignant esophageal legions
Advanced Diagnostic Motility Evaluation Services
The Gastroenterology Division of the Massachusetts General Hospital is 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. In addition, we offer more routine motility testing including esophageal manometry, 24 hour pH probe monitoring, and ano-rectal manometry.
Advanced Endoscopic Diagnosis and Treatment
We offer outpatients and 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 specialists 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 is composed of 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 esophagograms, 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
A Dedicated Referral Line for Physicians and Patients
We 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.
Calls will be returned within 24 hours.
Referring physicians can request these diagnostic studies by contacting the Swallowing and Heartburn Center’s access coordinator.
Clinical Research Studies & Trials
Our 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.
The Gastroenterology Division 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 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 is cancer that develops in the esophagus, the muscular tube that connects the throat to the stomach.
Gastroesophageal reflux disease (GERD) is a digestive disorder that is caused by gastric acid flowing from the stomach into the esophagus.
Gastroparesis is a stomach disorder in which the stomach takes too long in emptying its contents.
Halitosis is an oral health condition characterized by consistently odorous breath.
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.
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, 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.
An ulcer is an open sore, or lesion, usually found on the skin or mucous membrane areas of the body.
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.
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.
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).
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.
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).
A new capsule-like device may provide an alternative screening method for Barrett’s esophagus and esophageal cancer.
The MGH offers its first per-oral endoscopic myotomy (POEM) procedure, a new surgical treatment for achalasia.
Bob Hazelton lived with chronic acid reflux for years and was diagnosed with esophageal cancer in 2011. After his surgical team at Massachusetts General Hospital performed a minimally invasive esophagectomy, Bob has a healthy esophagus and is getting back to his active lifestyle.
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.