ailments and treatments

Treatments and solutions designed to bring you relief.

Esophagus and Associated Diseases

Esophagus and Associated Diseases

Northwest Institute for Digestive Surgery offers top–of–the–line surgical solutions for GERD. Historically, most patients chose minimally invasive surgical treatments because medications failed to relieve acid reflux symptoms. While this is still a leading cause of seeking a surgical solution, other reasons are becoming more common.  These include the inconvenience and cost of taking daily medications, the side effects produced by medications, and the desire to actually stop the reflux (medications only treat the symptoms, not the disease).

Learn more about these common ailments:


Gastroesophageal reflux disease (GERD) is a chronic condition of esophageal damage caused by stomach acid coming up from the stomach into the esophagus. Reflux can cause many symptoms including heartburn, indigestion, bloating, chest pain, regurgitation, cough, hoarse voice, and more. Chronic reflux can lead to esophagitis, strictures, Barrett's esophagus, and even esophageal cancer.



Endoscopy done different.

PillCam® uses a miniaturized camera contained in a disposable capsule that naturally passes through the digestive system, allowing us to directly view the small bowel, without sedation or radiation. With PillCam® we have the ability to quickly and efficiently detect and monitor abnormalities throughout the GI tract.



Tiny pill, enormous capabilities.

The SmartPill Capsule Motility Procedure is an exciting advancement in gastrointestinal healthcare. Once ingested, the SmartPill Capsule collects pressure, pH and temperature data from your GI tract and wirelessly transmits that information, allowing your physician to analyze. With just one capsule, we are able to obtain the information needed to better evaluate your condition.


Esophagogastroduodenoscopy (EGD)

Esophagogastroduodenoscopy (EGD) is a procedure where a flexible tube with a light and camera at the end, called an endoscope, is used to examine the lining of the esophagus, stomach, and first part of the small intestine.

High Resolution Manometry

High Resolution Manometry

Esophagus in HD

Esophageal manometry is done to see if the esophagus is contracting and relaxing properly. The test helps diagnose swallowing problems. During the test, the doctor can also check the Lower Esophageal Sphincter to see if it opens and closes properly.

Bravo Ambulatory pH Monitoring

Catheter-free monitoring

Bravo™ allows us to evaluate your heartburn symptoms to determine the frequency and amount of acid refluxing into your esophagus. Bravo is the world’s first catheter-free pH monitoring system that allows patients to maintain their regular diet and activities without the embarrassment and discomfort associated with traditional pH catheter systems.

Wats3D Biopsy

A more complete biopsy

The WATS3D Biopsy increases the tissue area we are able to sample, therefore, increases the yield of patients identified with abnormality in the esophagus. The WATS3D biopsy device is passed through the operating channel of a standard endoscope. WATS3D is specifically designed to consistently sample deeper layers of the more firmly attached glandular epithelium found in Barrett’s esophagus.


Endoflip is an advanced imaging system that provides an internal view of the gastroesophageal (GE) junction during endoscopic and surgical procedures. It captures vital measurements in the esophagus to assist in motility assessment and assists with tailoring surgical procedures to best fit each individual patient.

Esophagram (Barium Swallow)

Esophagram (Barium Swallow)

High Contrast Radiology

An Esophagram exam is completed in radiology where a contrast liquid is swallowed. We track the liquid through the esophagus and stomach where it can be observed to determine the function of these organs; specifically the ability to move food or fluid through effectively.



Combines pH and Impedance Testing for Patients

The Digitrapper reflux testing system monitors extra-esophageal symptoms and differentiates between reflux and non-reflux events to help you understand the root cause of reflux symptoms in our patients.



Acid can make its way up the esophagus and into the throat, a condition called Laryngopharyngeal Reflux (LPR). LPR symptoms may include chronic cough, sore throat, throat clearing, and voice hoarseness. Restech is a 24hr pH system that measures acid levels in your airway to obtain objective evidence of LPR.

Laparoscopic Fundoplication

Historically, the most common surgical procedure used to treat reflux disease is the Nissen Fundoplication. This procedure was developed in 1958. During this procedure, hiatal hernias are reduced and the diaphragmatic hiatus is repaired by suturing the diaphragmatic muscle. The upper portion of the stomach is then wrapped behind the esophagus and tied to itself. In describing this operation we refer to this as being like a "hot dog in a bun". Since the early 1990s, the majority of experienced surgeons perform this operation with a laparoscopic minimally invasive technique. Dr. Pennings and Dr. Richardson perform this operation with a minimally invasive technique.



A short procedure, a new lease on life.

Unlike other procedures to treat reflux, LINX is implanted around the outside of the Lower
Esophageal Sphincter (LES) and requires no alteration to the stomach. This simple, minimally invasive laparoscopic procedure starts to have a positive impact from day one. LINX is designed to start working the moment the device is implanted.

Gastric Exclusion

This procedure is for patients with previously failed anti-reflux procedures, or those with a high body mass index. The gastric exclusion with small bowel diversion is a great solution that reroutes the esophagus to the small intestine.  Acid from the stomach can no longer come in contact with the esophagus, resulting in resolution of reflux symptoms and protecting the esophagus from further damage caused by acid exposure.

TIF Procedure

The transoral incisionless fundoplication (TIF) is a minimally invasive treatment for gastroesophageal reflux disease (GERD) that is performed in the outpatient setting. The TIF procedure is performed from inside the patient’s stomach without incisions. This procedure delivers patient outcomes similar to those provided by conventional anti-reflux surgical procedures, but is less invasive, has fewer adverse effects, and does not limit future treatment options.

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Northwest Institute for Digestive Surgery - The Digestive Health Experts.