Persistent Heartburn
A burning sensation rising behind the breastbone, typically worse lying flat, after large meals or on bending forward.
Esophagus
Specialist Treatment for Esophageal Conditions
Precise diagnosis and lasting treatment for reflux disease, achalasia, hiatal hernia and swallowing disorders — because difficulty swallowing is never normal.
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pH study monitoring
Overview
Understanding Esophageal Disease
The oesophagus is a muscular tube that moves food from throat to stomach by coordinated waves of contraction. A valve at its lower end opens to let food through and closes to keep acid out. Almost all oesophageal disease is a failure of one of those two functions — the muscle or the valve.
When the valve fails, acid refluxes upward and causes heartburn. Persistent reflux over years can change the lining of the lower oesophagus into an intestinal-type epithelium, a condition called Barrett's oesophagus. Barrett's is not cancer, but it is the recognised precursor to adenocarcinoma, which is why it is kept under surveillance.
When the muscle fails, swallowing itself becomes difficult. Achalasia — where the lower valve does not relax — produces a slow, progressive obstruction that patients often adapt to for years before seeking help. Any difficulty swallowing that is getting worse, particularly progressing from solids to liquids, needs an endoscopy promptly.
Discuss Your Reports
Symptoms
Signs and Symptoms to Watch For
None of these confirms a diagnosis on its own. Each is a reason to be examined rather than to wait and see how things develop.
Difficulty Swallowing
A sensation of food sticking. Progression from solids to liquids over months is the pattern that most demands prompt investigation.
Regurgitation
Undigested food or sour fluid returning to the mouth without nausea, particularly at night, sometimes staining the pillow.
Chronic Cough or Hoarseness
Reflux reaching the larynx causing a persistent dry cough, throat clearing or voice change, often mistaken for a respiratory problem.
Non-Cardiac Chest Pain
Squeezing central chest pain from oesophageal spasm that can closely mimic cardiac pain and must be distinguished from it first.
Weight Loss with Dysphagia
Losing weight because swallowing has become difficult is a red-flag combination requiring urgent endoscopy.
Causes & Risk
Causes and Risk Factors
Understanding what drives the condition is what makes prevention and early detection practical rather than theoretical.
Causes
- Lower Sphincter IncompetenceA weak or inappropriately relaxing valve at the gastro-oesophageal junction allowing acid and bile to reflux upward.
- Hiatal HerniaPart of the stomach sliding through the diaphragm into the chest, disrupting the anatomy that normally keeps the valve competent.
- Achalasia and Motility DisordersDegeneration of the nerve plexus in the oesophageal wall, so peristalsis fails and the lower sphincter does not relax.
- Peptic Stricture and Barrett's ChangeYears of acid exposure producing fibrotic narrowing, or metaplastic transformation of the lining into intestinal-type epithelium.
Risk Factors
- Obesity and Central AdiposityRaised intra-abdominal pressure is the strongest modifiable risk factor for reflux and for hiatal hernia formation.
- Smoking and AlcoholBoth reduce sphincter tone and impair mucosal healing. They are also the principal risk factors for squamous cell carcinoma of the oesophagus.
- Long-Standing RefluxThe duration of reflux, more than its severity, determines the risk of developing Barrett's oesophagus and its subsequent complications.
- Dietary and Postural HabitsLarge late meals, caffeine, and lying down soon after eating each provoke reflux and are among the easiest factors to change.
Diagnosis
How We Reach a Diagnosis
Only the investigations that will change a decision are ordered, and they are sequenced so results build on one another rather than repeating.
Upper GI Endoscopy
Direct visualisation of the lining to identify oesophagitis, stricture, hernia or Barrett's change, with biopsy where indicated.
Esophageal Manometry
Measures the pressure and coordination of the muscular contractions, and is the definitive test for achalasia and motility disorders.
24-Hour pH Monitoring
Quantifies actual acid exposure over a full day, distinguishing true reflux disease from symptoms with another cause.
Barium Swallow
A dynamic study showing the shape of the oesophagus and how a bolus travels, particularly useful for strictures and large hernias.
Endoscopic Ultrasound
Assesses depth of invasion when a tumour is found, which determines whether endoscopic resection is adequate.
Treatment
Treatment Options
Treatment is matched to the stage and to the individual. Not every option below applies to every patient, and the right choice is made together.
Lifestyle and Dietary Therapy
Weight reduction, smaller earlier meals, head-of-bed elevation and trigger avoidance, which control symptoms in a substantial proportion of patients.
Acid Suppression
Proton pump inhibitors to heal oesophagitis and control symptoms, reviewed periodically rather than continued indefinitely without reassessment.
Dilation and Ablation
Balloon dilation for strictures and achalasia, and radiofrequency ablation for dysplastic Barrett's segments, both performed without incisions.
Laparoscopic Fundoplication and Heller Myotomy
Keyhole reconstruction of the valve for refractory reflux, or division of the lower sphincter muscle for achalasia, with a partial wrap to prevent reflux.
Why Advitya
Why Choose Advitya Healthcares
Specialist surgical care, delivered close to home, without asking families to relocate for months of treatment.
Experienced Specialists
A dedicated hepato-pancreato-biliary and gastrointestinal surgical team, operating on these conditions as their principal practice rather than occasionally.
Advanced Diagnostics
Endoscopy, endoscopic ultrasound, MRCP and protocol-specific cross-sectional imaging interpreted by clinicians who treat the disease themselves.
Modern Treatment Facilities
Fully equipped theatres, high-dependency support and endoscopy suites, delivered in partnership with hospitals close to where patients live.
Minimally Invasive Procedures
Laparoscopic and endoscopic approaches wherever they are the right choice, with shorter stays, less pain and a faster return to ordinary life.
Personalised Patient Care
Reports reviewed before you travel, decisions explained in your own language, and a plan built around your circumstances rather than a protocol.
24/7 Emergency Support
Acute pancreatitis, cholangitis and obstructive jaundice do not keep office hours. Our team is reachable when they present.
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Procedures supported
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Years of specialist practice
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Partner hospital locations
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Emergency availability
Our Specialist
Meet the Specialist
Dr. Deeksha Kapoor
Surgical Gastroenterology and GI Surgical OncologyDr. Kapoor leads Advitya's gastrointestinal and hepato-pancreato-biliary practice, with a focus on complex pancreatic, biliary and liver surgery. Her work centres on bringing specialist-level surgical care to regional hospitals, so that patients can receive the operation they need without leaving their families behind.
Pancreato-Biliary-Liver Surgery · Gastrointestinal Surgery · Surgical Oncology
Patient Journey
What to Expect With Us
Four steps, explained before they happen, so you always know what comes next.
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Consultation
We begin with your history and your existing reports. Bring every scan and biopsy — they shape the plan more than the symptoms do.
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Diagnosis
Only the investigations that will change a decision are ordered, sequenced so that you are not sent back and forth between departments.
03
Treatment Planning
Complex cases are discussed jointly by surgery, oncology and radiology, and the plan is explained to you and your family in full before anything begins.
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Recovery & Follow-up
Structured recovery with nutritional and physiotherapy support, and a defined follow-up schedule so nothing is left to chance.
FAQ
Frequently Asked Questions
Straight answers to the questions patients ask most often in clinic.
It can be. Reflux that persists for years exposes the lower oesophagus to repeated acid injury and can lead to Barrett's oesophagus, which carries a small but real risk of progressing to cancer. Symptoms present for more than five years, or requiring continuous medication, are grounds for at least one endoscopy.
It always warrants investigation. Progressive difficulty that begins with solids and later involves liquids suggests a mechanical narrowing — a stricture or tumour. Difficulty with both solids and liquids from the outset is more typical of a motility disorder such as achalasia.
For many patients, yes. Weight reduction and dietary change alone control symptoms in a substantial proportion. For those with a hiatal hernia or a genuinely incompetent valve, laparoscopic fundoplication offers a durable mechanical solution and frees most patients from daily medication.
It is a change in the lining of the lower oesophagus, where normal squamous cells are replaced by intestinal-type cells in response to chronic acid exposure. It is not cancer and most patients with it never develop cancer, but it is monitored by periodic endoscopy because it is the recognised precursor lesion.
The aim is to relieve the obstruction at the lower sphincter. Options include pneumatic balloon dilation, botulinum toxin injection for patients unfit for other treatment, and laparoscopic Heller myotomy, which divides the muscle and provides the most durable long-term result.
Laparoscopic fundoplication is performed through five small incisions, usually with a one to two night stay. A soft diet is needed for the first two weeks while swelling settles, and normal activity resumes within two to three weeks.
Get Expert Care for Your Digestive Health
Connect with our experienced specialists for personalised diagnosis and treatment.
+91 9211221551 · info@advityahealthcares.com · Reports reviewed before you travel