BreAnne Gendron, NP, knows all about the effects of gastroesophageal reflux disease, or GERD. She eventually had to give up coffee because it caused a burning sensation in her throat.

As a nurse practitioner with OSF HealthCare, Gendron also treats patients who experience GERD in different ways.

“GERD probably feels a little bit different for everybody, but it definitely helps [to understand patients' experience] when you have personal experience with it,” she says. “Sometimes people with GERD have a flare-up and their stomach hurts, but they don't get that acid-up-the-throat feeling. It just causes stomach discomfort. Sometimes it changes bowel movements. Everybody has a slightly different version of it.”

Occasional heartburn or acid reflux is common. But when those symptoms happen frequently – two or more times a week – it could be a sign of GERD and worth mentioning to your health care provider.

Symptoms can include regurgitation, trouble swallowing, a feeling of a lump in your throat, a persistent cough, a sore throat or heartburn that doesn’t improve with over-the-counter medication.

Gendron says people who are 50 and older and overweight are at highest risk for GERD. Heartburn is one of the most common symptoms of GERD. But how do you know if that burning sensation in your chest is simply reflux or something more serious, such as a heart problem?

When chest pain shouldn't be ignored

Gendron says patients will sometimes go to the emergency department because they are experiencing chest pain. While some people may wonder if they are overreacting, Gendron says it’s always better to have potentially serious issues addressed.

“If it’s the first time you're having chest pain, we can't just guess, ‘Oh, that's probably acid reflux,’” she says. “You have to go in and be seen to rule out a cardiac reason, because that's what we do in health care. We rule out the scary stuff, so we can treat the treatable stuff.”

Even people with a history of GERD should pay attention when their symptoms change. For example, if chest discomfort occurs during physical activity, it could be a sign of a heart problem and should be evaluated.

“I would say any time you have activity where you're carrying in the groceries or you're going up a couple flights of stairs and that pain happens, that's not a GERD symptom,” Gendron says. “That's a cardiac symptom, and your doctor can help you figure that out. It's worth a conversation if you're having reflux feelings that are different than normal.”

If you experience new, severe or unexplained chest pain, especially with symptoms such as shortness of breath, sweating, nausea, dizziness or pain that spreads to the arm, back, neck or jaw, seek emergency medical care immediately.

Knowing your GERD triggers

Once anything serious has been ruled out, lifestyle changes can help manage GERD symptoms.

Common triggers can include spicy or fatty foods, citrus or tomato-based foods, caffeine and soda, alcohol, nicotine and heavy or late-night meals.

Gendron says there isn't one diet that works for everyone with GERD. Instead, people should pay attention to which foods trigger their symptoms and make adjustments as needed.

“Some foods will bother people,” she says. “I hear people complain to me a lot about things with tomato sauce, so pizza and spaghetti and things like that bother people with acid reflux. So, you can augment your diet. You can cut back on coffee. You can cut back on your nicotine.”

Medication can also be used to treat GERD when lifestyle changes aren't enough. But Gendron says she prefers to start with lifestyle changes if possible.

For her, that meant giving up her favorite morning beverage.

“I personally had to give up coffee because of this problem. I know if I don't drink coffee, that my whole digestive tract is happier,” she says. “So, people will figure out which foods bother them, and then you have to avoid those.”

Interview Clips

According to the National Institute of Diabetes and Digestive and Kidney Diseases, 20% of people in the United States have gastroesophageal reflux, commonly referred to as GERD. One of the complications of GERD is esophageal stricture, when a person’s esophagus becomes too narrow. This can lead to major problems with swallowing.

There’s a minimally invasive procedure available that can provide serious relief for patients dealing with these issues. One that can be done in one sitting and have you back to normal life as soon as you leave the hospital.

Introducing upper endoscopy

"This procedure is an upper endoscopy. We frequently refer to it as EGD (esophagogastroduodenoscopy). There are various treatments we can do with this procedure, including balloon dilation," says Raza Hamdani, MD, attending gastroenterologist at OSF HealthCare St. Mary Medical Center in Galesburg, Illinois. "Balloon dilation is one of the techniques we have for patients who have obstruction of the esophagus."

Common complaints that lead to EGD:

The main complaint seen when patients get referred for an EGD is difficulty swallowing certain food like bread or meat. However, depending on the severity, it can even be soft foods or liquids causing issues while being consumed.

“It's usually described as a sensation of choking or things slowing down," Dr. Hamdani says. "Things not being able to go through”

Carrie McCance, the public relations communications coordinator (PRCC) at OSF St. Mary, usually is creating content about the work OSF providers do. This time, she has become part of the story.

“I was having frequent issues with food getting stuck in my esophagus, so much so that I couldn’t even swallow bread. After undergoing an X-ray, I was diagnosed with dysphagia, which is the medical term for difficulty swallowing,” McCance says.

McCance spoke with her care team at OSF and underwent an X-ray to try and get answers. The X-ray revealed she had scar tissue in her esophagus created by acid reflux, creating an esophageal ring that narrowed her esophagus.

“A normal esophagus measures about 20 millimeters in diameter, but mine had narrowed to 12 millimeters,” McCance says.

How the upper endoscopy works

McCance decided to get the upper endoscopy procedure, performed by Dr. Hamdani. Done under sedation, a thin, flexible tube called an endoscope gently passes through the patient’s throat.

A dilating balloon that has been inserted through the scope is carefully inflated, stretching the esophagus back to its normal size.

“This definitely improved my swallowing,” McCance explains.

Her treatment became a family affair, after Carrie’s mother, Mary Guenther, who had been experiencing similar issues, saw McCance go through the process.

“I was happy she told me about this. After I saw her go through the procedure without issues, it was easier for me to go through the process,” Guenther says.

Guenther’s esophagus was even narrower than McCance’s, at eight millimeters. Guenther says she went directly from the hospital and out to breakfast, and her swallowing has been better ever since.

McCance says having this procedure available in Galesburg saved her from hours of travel time, which she is very grateful for.

“I was in and out of the hospital within just a few hours. It couldn’t have been more convenient. Originally, I was expecting to travel to Peoria for the procedure, but thanks to Dr. Hamdani coming to the area, I was able to receive care close to home,” McCance says. “It also meant a lot to have the same option available for my mother. Being able to take her in for her procedure and have her back home in less time than would take just to drive to and from a larger city made a big difference for the both of us.”

What puts people at risk:

For those with trouble swallowing, it normally starts off with a slight feeling and then progresses to a “strong sensation,” Dr. Hamdani points out. This looks like food items are not passing through the throat or even getting stuck. This can even send some patients to the emergency department.

"If you cannot control the acid sensation or burning. Or even if you can, but you've had that kind of sensation for several years, that puts you at some risk for developing scar tissue and obstructions," Dr. Hamdani adds.

Dr. Hamdani encourages patients to "take action" if they are experiencing these complications, just like McCance did.

“Having this procedure truly changed my life. I can now eat without the constant fear of food getting stuck in my esophagus,” McCance adds.

Dr. Hamdani and McCance agree, saying first speak with your primary care provider. They can start by prescribing medications that can help relieve symptoms. If these symptoms don't go away completely, then you should get further consultation with a gastroenterologist to prevent issues from becoming more serious.

Acid reflux isn’t the only challenge these patients can face. Allergies can also affect the esophagus, creating the need for an EGD procedure.

For more information on gastroenterology specialists in the Greater Galesburg region, visit the OSF HealthCare website.

Video Interview Clips

Here’s an eye-opening observation from John Rinker, MD: Some people think just because you can get a medication over the counter, you can play fast and loose with its use.

“Because it’s widely accessible and they can easily get it from their grocery store, they sometimes don’t even view it as actual medicine,” says Dr. Rinker, an internal medicine physician at OSF HealthCare. They view it more like a vitamin, he says.

Complicating matters: Due to issues like a lack of mobility, older adults might skip getting the right prescription from a health care provider in favor of a pharmacy shelf option. Dr. Rinker warns that route could lead to unintentional medication misuse and possibly deadly side effects. Luckily, there are tips to steer your loved one back onto the right path.

Common barriers and issues

A big issue for older adults is not being able to move like they used to. So, if someone is dealing with a health problem (back pain, for example), it’s tempting to skip the long drive to the doctor’s office and just go to the pharmacy a block away. Or, the person might have medication delivered and not leave home at all.

Seniors can also be more forgetful or have trouble reading medication labels, leading to instances where they take too much of a drug. And Dr. Rinker says as we age, our ability to break down medicine and clear it from our body diminishes. The liver and kidneys just don’t work as well as they used to.

“That’s why we often adjust doses of medicine for adults as they age. We deescalate the dose. Less is more in certain cases,” Dr. Rinker explains. “The dose can last longer. The byproducts of the drug are more likely to create another problem.”

Some common over the counter medicines that are unintentionally misused, according to Dr. Rinker:

• A pain reliever like ibuprofen or Aleve (the technical term is a non-steroidal anti-inflammatory)
  
  “If it’s used temporarily, it’s probably not problematic. That’s how those drugs are meant to be used. But so many people have chronic conditions like arthritis. They’ll take these drugs for long lengths of time,” Dr. Rinker says. “That’s when we start to run into more of those long-term effects. You worry about gastric ulcers or bleeding in your gastrointestinal area. If you have underlying kidney issues, those drugs can make that more harmful.”
   
• Acid reflux medication like Nexium or Prilosec (technical term: proton pump inhibitor). Again, Dr. Rinker says a person might keep taking these drugs past their intended use.
  
  “This can create issues with how you absorb nutrients like calcium and vitamin D. It can lead to bone and kidney problems,” Dr. Rinker warns.
   
• Sudafed (also called pseudoephedrine) or Afrin for nasal congestion.
  
  “If you have an enlarged prostate, [overuse of Sudafed] can create more of an issue. You’ll have more problems urinating,” Dr. Rinker warns. Sudafed can also raise your blood pressure, he says.
  
  Afrin, meanwhile, should only be used for a few days, Dr. Rinker says. If you use it longer then stop, he says you can actually get “rebound congestion” that’s worse than before.
   
• Benadryl (also called diphenhydramine) for allergies or to aid sleep.
  
  “It can impair cognition and increase the risk of a fall,” Dr. Rinker says. Falls can lead to serious injuries in seniors like hip fractures.

And for all medications, Dr. Rinker adds they can negatively interact with each other. For example, he says you shouldn’t take ibuprofen with a blood thinner because it could impact how the blood thinner works and make you more prone to internal bleeding.

Strategies to stay healthy

Things for seniors and their caregivers to consider:

• Look into ways to remove the travel barrier to visit your health care provider. See if a friend, family member or social service agency can give you a ride. Or, see a provider virtually. Dr. Rinker says this could be as simple as calling or messaging your provider on your patient portal and asking, “Is it safe for me to take this drug?”.
   
• Caregivers should closely watch their loved one’s medication use and their behavior afterward. For example, did one particular pill make grandma woozy? It’s worth looking into if the regimen should be changed. Don’t be afraid to ask tough questions like, “I saw you take that pink pill earlier today. Are you sure you need another?”.
  
  “Just because they’ve taken it for a while doesn’t mean the drug is OK,” Dr. Rinker says.
   
• When you do visit a health care provider, make sure they know your health history and which medications you’re taking.
  
  “You can read medicine packaging, but sometimes it’s really difficult to understand the language. It’s not always clear cut for the average person,” Dr. Rinker points out. “So, your primary care provider is the best person to ask questions of. They’ll have your chart and other information. They can give you a response that’s tailored to your needs.
  
  “Your provider might have a different prescription medication or a safer over the counter alternative that works well for you. Or maybe they can figure out a way for you to take your current drug in a healthier manner,” Dr. Rinker adds.

Learn more

Read more about staying healthy in your golden years on the OSF HealthCare website.

Interview clips

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Fall and winter could be renamed “coughing season” with seasonal illnesses in the air. But there’s more to coughing than the brief but annoying impact on your day.

Some coughing is normal. But you should see a health care provider quickly when you cough up things you shouldn’t.

The basics: Why do you cough?

Aminat Ogun, MD, a family medicine physician at OSF HealthCare, says coughing is one way your body protects your lungs and airways from irritants. You expel the bad stuff out of our system, she says.

Some everyday things that can make you cough: breathing in smoke, allergies and mucus dripping down to your throat and irritating it. Or, you may just wake up in the morning and cough a few times to lighten your chest. These shouldn’t alarm you, Dr. Ogun says.

“We have cough receptors in our airways and lungs,” Dr. Ogun explains. “If we have mucus or an irritant, there’s a signal sent to our brain. The brain activates those receptors to have the cough action happen. So that’s why you clear your throat or cough in the morning. You’re trying to clear out your airways.”

If your cough is associated with an illness (like a cold, flu, RSV, COVID, bronchitis or pertussis, also called whooping cough) or a chronic condition (like asthma or COPD), you should be seeing a provider as often as needed to learn how to manage things.

Coughing up things you shouldn’t

Watch for signs that your cough may be linked to a more serious problem, Dr. Ogun says.

• Mucus: Our airways produce mucus to trap irritants, Dr. Ogun says. So it’s not out of the ordinary to cough up mucus from time to time. But if the mucus is thick or a different color (green or yellow), it could be a sign of pneumonia or bronchitis.
  
  “When it’s persistent [cough with mucus] and it’s affecting your breathing, you definitely want to be seen [by a provider,]” Dr. Ogun says.
   
• Vomit: Dr. Ogun says sometimes, you just cough hard enough to bring up some vomit. If it’s a “one-off,” as she calls it, you should still see a provider, but it may not be cause for great concern. But persistent vomiting while coughing could be a sign of whooping cough, acid reflux or aspiration (when food or drink gets into the lungs).
   
• Blood: Coughing blood brings a high level of concern, Dr. Ogun says.
  
  “Sometimes you have the common cold, you’re coughing for a long period and you irritated your airways. Maybe you nick the capillary artery [leading to coughing blood.] That’s fine,” Dr. Ogun says. “But more serious conditions would be a blood clot in the lung or tuberculosis.”
  
  Heart failure, lung cancer or infections are also associated with coughing up blood.
   

Diagnosis and treatment

When you see a provider for an abnormal cough, they’ll ask about your health history, specifically about your cough. How long have you been coughing? Did something trigger it? What are you coughing up? Do you have other symptoms, like a fever?

“Then the provider could do a physical examination. They look at the back of your throat. They listen to your lungs to see if they hear anything concerning. Depending on what they find, they could order a chest X-ray or a CT scan to see what’s going on inside your chest,” Dr. Ogun says.

Treatment will depend on what the provider finds. For example, acid reflux can be tamped down by an antacid or a proton pump inhibitor (PPI). For an infection like pneumonia, you’ll get an antibiotic. If it is just an irritating tickle in your throat, you may get a steroid like Flonase.

What you can do

Some advice from Dr. Ogun to ensure coughs don’t derail your health:

• Parents should keep a close eye on kids and their coughing.
   
• No matter the age, don’t shake off one instance of a bad cough and assume things will go back to normal. See a provider right away.
   
• While vaccines don’t prevent coughing, Dr. Ogun says they are critically important to stomp out the illnesses associated with coughing. Talk to your health care provider about when you’re due for flu, COVID, RSV, pneumonia and Tdap (tetanus, diphtheria and pertussis) vaccines.
  
  “Pertussis is dangerous in immunocompromised people and kids,” Dr. Ogun warns. “RSV is highly contagious, as well. It’s life-threating in infants and older adults.
  
  “What vaccines do is help prevent getting to the very severe stage [of an illness,]” she adds. “You’re trying to prevent ending up in the hospital. You’re also reducing the risk of infection. And you’re protecting people around you who may be sicker than you.”
   
• Daily hygiene habits also go a long way. Sneeze or cough into your elbow or a tissue. Wash your hands often. Stay home and away from others when sick. Again, these don’t prevent coughs. But they can help prevent the spread of illness that brings those rough coughing fits.

Interview clips

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In his year-long battle with cancer of the esophagus, Jim Corby encountered many nerve-wracking moments.

But when asked about it, one memory comes to mind for the retired construction worker from Alton, Illinois. One that happened far away from a doctor’s office.

On July 27, 2022, Corby was chosen to throw the ceremonial first pitch at the Alton River Dragons baseball game. Members of care team at OSF HealthCare Moeller Cancer Center in Alton, James Piephoff, MD, and Manpreet Sandhu, MD, were at his side. Also watching was a group of young women Corby coaches on the softball diamond.

“He knew if he didn’t throw a strike, he would never hear the end of it from the girls on his team,” Dr. Piephoff says.

No pressure, Jim.

Esophageal cancer: The basics

Dr. Piephoff, a radiation oncologist, says around 20,000 people in the United States are diagnosed with esophageal cancer each year. The cancer claims around 16,000 lives in the U.S. each year.

There are two types. The most common (around 70% of U.S. cases) is adenocarcinoma in the lower esophagus. The other type is squamous cell carcinoma, typically above where the airway separates into the lungs.

Both types are associated with excess smoking and drinking, something Corby found out the hard way.

“I smoked two-and-a-half to three packs of cigarettes a day,” Corby says. “The day I went in for surgery, I threw them out the window. I haven’t smoked since.”

Obesity is also a risk factor for adenocarcinoma.

“Obesity leads to increased risk of gastroesophageal reflux disease,” Dr. Piephoff explains. “It’s the acid churning up in the lower esophagus that leads to the risk of developing what’s called Barrett’s esophagus. That’s a precancerous condition.”

Screening isn’t common for cancer of the esophagus, so Dr. Piephoff says it’s important to watch for symptoms, which can mimic those of heartburn. See a doctor if symptoms won’t go away.

“Know your body. Don’t be afraid to talk to your doctors about it. Don’t try to minimize your symptoms,” Dr. Piephoff urges. “If there’s a change you notice, you need to convey that to your doctor.”

On treatment, Dr. Piephoff says he typically sees a person go through chemotherapy and radiation to shrink the cancer followed by surgery to remove the tumor. During surgery, instruments are sent down the throat and not through the chest, meaning an easier recovery for the person. Early detection could mean surgery only.

“There are some patients who are not able to have surgery because of medical conditions like a bad heart or bad lungs,” Dr. Piephoff says. “They get treated with radiation and chemotherapy without surgery.”

Immunotherapy is also a part of the treatment plan for some people. This involves changing how your immune system works so it can fight cancer, according to the American Cancer Society.

Jim’s journey

Corby says he started having pain in his midsection last year when he ate. Treatment for heartburn and acid reflux didn’t help. An ultrasound and CT scan didn’t get his doctors any closer to a solution. All the while, Corby says it hurt so much to eat, he started losing weight.

In September 2021, doctors examined Corby’s esophagus with a camera.

“The doctor came in and sat down, which I knew was not a good sign,” Corby recalls.

“That day was when my life changed,” he says.

The exam found a cancerous mass in Corby’s lower esophagus. The next few months were a whirlwind.

“It happened real fast,” Corby says.

“They got me here [to Moeller Cancer Center] to see Dr. Piephoff and Dr. Sandhu. They came up with a program to try to get me going,” Corby says. “I went through chemotherapy and radiation first. Then they sent me over to St. Louis, and in January I had surgery.”

The surgery to remove the cancer preceded a nine day stay in the hospital where Corby says he couldn’t eat or drink aside from the occasional ice cubes or water sopped from a sponge.

Sometime later – Corby can’t remember exactly when – he was back at OSF Moeller Cancer Center meeting with Dr. Sandhu.

“She said ‘Your scan came back. You’re cancer free.’” Corby says.

“I couldn’t believe it,” Corby adds. “How many times do you hear about people who have cancer who die? You hear more of that than you do cancer free.

“The odds were against me 100%, but I guess I beat the odds.”

The first pitch

Corby’s first pitch at the River Dragons game went – where else? – right down the middle of the plate, eliciting a cheer from his support system and all the fans learning his story for the first time. For Corby, it was a sigh of relief. No need to worry about razzing from his softball players.

“I got lucky,” Corby says, fighting back happy tears.

Learn more

Visit the OSF HealthCare website to learn about cancer treatment. This includes the new OSF Cancer Institute in Peoria, Illinois, which will serve the entire OSF service area will the latest treatment, education and more.

Interview clips - Dr. James Piephoff

Interview clips - Jim Corby