Explore This Program

About the Program

As part of the Massachusetts General Hospital Digestive Healthcare Center, the Swallowing, Heartburn and Esophageal Disease Center (SHED) brings together a multidisciplinary team of gastroesophageal specialists who provide expert diagnosis, cutting-edge medical and surgical interventions and ongoing care for benign throat, esophagus and stomach disorders.

Our board-certified digestive health specialists work together to help patients diminish episodes of discomfort, including:

  • Chronic cough
  • Chronic heartburn
  • Difficulty swallowing
  • Noncardiac chest pain
  • Postsurgical esophageal symptoms

Diagnosis and treatment may include a combination of medication, lifestyle changes, endoscopic therapies and, when appropriate, surgical procedures.

Mass General surgeons and gastroenterologists work collaboratively to provide comprehensive, personalized treatment for patients with gastroesophageal conditions. Our surgeons specialize in complex surgical techniques, such as Transoral Incisionless Fundoplication (TIF procedure) and magnetic sphincter augmentation (LINX procedure), which are both procedures for the treatment of gastroesophageal reflux disease (GERD), and endoscopic myotomy (POEM procedure) for the treatment of achalasia. 

Advanced Diagnostic Motility Evaluation Services

We provide highly specialized, expert analysis for a range of diagnostic and therapeutic procedures. Our endoscopists are available 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
  • EndoFLIP, cutting-edge technology for evaluating esophageal motility

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 identify speech and language deficits

Conditions We Treat

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:

Achalasia

An esophageal disorder that makes swallowing difficult, often causing weight loss and other undesirable outcomes. It occurs when the muscle at the bottom of the esophagus that normally functions as a valve fails to relax, preventing food from entering the stomach.

Esophageal Diverticulum

A pouch of stretched tissue that branches out from the esophagus. The most common location for this condition is the cervical esophagus, referred to as Zenker’s diverticulum.

Gastroesophageal Reflux Disease (GERD)

A digestive disorder that is caused by gastric acid flowing from the stomach into the esophagus.

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Hiatal Hernia

A condition that occurs when the upper part of the stomach pushes up into the chest through a small opening in the diaphragm, resulting in retention of acid and other contents that can easily back up (reflux or regurgitate) into the esophagus.

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Paraesophageal Hernia

A type of hiatal hernia where the stomach pushes through the diaphragm alongside the esophagus to lie in the chest.

Care During COVID-19

Our dedicated physicians, nurses and staff are committed to providing the best possible specialty care⁠—safely and effectively. We have taken unprecedented steps to ensure office visits and procedures (endoscopy and surgery) are welcoming and safe. Your health is our top priority.

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

Our collaborative physicians specialize in the surgical treatment of GERD and hiatal hernias. In addition, we are a leading resource for patients who have had previously unsuccessful antireflux operations.

As a high-volume center, we have achieved excellent results in repairing hiatal hernias and relieving patients of GERD symptoms. Nearly 75% of patients undergoing surgery can discontinue acid suppressive medications and more than 90% 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.]

Easy Access for Patients & Referring Physicians

We pair patients and referring physicians with an experienced care coordinator who helps assess patient needs and coordinates all necessary appointments and tests.

All requests are triaged the same day, and the patient and referring physician will be called back to schedule an appointment within one business day. Patients and referring physicians may request an appointment online or call 617-724-1020 to speak with our care coordinator.

Procedures

Minimally Invasive Procedures

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:

Magnetic Sphincter Augmentation (LINX)

A flexible band of magnetic titanium beads is placed around the esophagus to support the lower esophageal sphincter (the muscle that opens and closes to allow food to enter and stay in the stomach) by restoring the body’s natural barrier to reflux (treatment for GERD).

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Laparoscopic Anti-Reflux Surgery

Treatment for GERD and hiatal hernias.

Laparoscopic Repair

Typically of an enlarged opening in the diaphragm (treatment for hiatal and paraesophageal hernias).

Per Oral Endoscopic Myotomy (POEM)

Using a specialized endoscopic tool, a small slit is made in the inner lining of the esophagus to tunnel down to the sphincter muscle. The muscle fibers that block the passage of food are divided, and the slit in the esophagus is repaired (treatment for achalasia).

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Laparoscopic Heller Myotomy

Small incisions are made in the abdomen to allow access to the esophageal sphincter muscle, where the muscle fibers that block the passage of food are divided (treatment for achalasia).

Endoscopic, Transoral Treatment for Zenker’s Diverticulum

A specialized instrument is passed through the mouth to divide the common wall between the Zenker's diverticulum and the esophagus, opening the diverticulum and splitting the muscle. This approach avoids a traditional neck incision.

Laparoscopic Procedures

For cancers and GIST tumors of the esophagus, stomach and gastroesophageal junction.

Transoral Incisionless Fundoplication (TIF)

A minimally invasive procedure with no incisions in the abdomen to treat gastroesophageal reflux disease (GERD).

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Reoperative Hiatal Hernia Surgery
Reoperation for recurrent hiatal hernias after prior hiatal hernia surgery.
Per Oral Pyloromyotomy (POP)
Gastroparesis (delayed gastric emptying) occurs when the stomach takes too long to empty out food—a disorder caused when the vagus nerve is damaged or otherwise stops working. One treatment for gastroparesis is POP, a technique that allows surgeons to open up the pylorus using only a gastroscope, as opposed to the traditional treatment that requires an open or laparoscopic surgical procedure.

Clinical Research Studies and 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 (TIF).