Ervin Monroe's heartburn was so bad at times that he thought he might be having a heart attack. Every day, acid from his stomach seeped up into his esophagus and even into his mouth.

"My acid reflux got so bad that I couldn't drink sodas, because they would burn my tongue, and I could hardly even drink water," says Monroe, who lives in Lillington.

Monroe is a longtime member of the Mighty Sons of Faith gospel group, but his voice wasn't sounding so mighty because of the acid that irritated his throat.

For years, he had taken every over-the-counter antacid on the market, but they relieved his pain for only a few minutes. His doctor prescribed high-powered acid suppressants. Some worked pretty well for a while, but none gave him lasting relief.

Early this year, Monroe's doctor referred him to the Esophageal Center at First-Health Moore Regional Hospital, where specialists diagnosed a change in the lining of the esophagus called Barrett's mucosa. The condition is caused by gastroesophageal reflux disease (GERD), which is the chronic splashing of stomach acid into the esophagus.

"Once Barrett's mucosa forms, there is a risk of abnormal tissue growth that can sometimes progress to esophageal cancer," says Dr. Wayne Lucas, a gastroenterologist with Pinehurst Medical Clinic and medical director of the Esophageal Center. "The percentage of cases in which that occurs is very small, but with so many people now having reflux disease, the number who go on to develop more serious problems is significant."

Most cases of GERD can be controlled with medication and diet, but some patients require surgery to support the muscle at the base of the esophagus that is supposed to tighten and keep stomach acid in the stomach.

Surgery is most often recommended for patients who, like Monroe, "continue to have breakthrough symptoms on medication," says Dr. Michael Rowland, a general surgeon with Pinehurst Surgical.

Rowland explained to Monroe that the surgery involved wrapping part of his stomach around the base of his esophagus to reinforce the faulty muscle.

"I told him to do whatever it takes to keep me from having to take pills the rest of my life," Monroe recalls.

Within a few months, the surgery had made him feel like new.

""I don't feel any more pain, and I can eat whatever I want, but I still try to be careful," he says.

Monroe has lost quite a lot of weight, because he can't eat nearly as much at one time as he used to.

"The surgery reduces the stomach capacity, because we use the large upper part of the stomach to do the wrap," Rowland says.

Janet Wright, who lives in the Anson County community of Peachland, also suffered from acid reflux for years. But instead of triggering intense heartburn, the constant flow of acid into her throat caused pre-cancerous growths to form on her vocal chords.

"I got laryngitis pretty often, and it started staying with me longer and longer," she says.

After twice having growths on her vocal chords removed, she decided to have surgery to eliminate the excessive acid reflux. A few months later, she still has some hoarseness, but is doing much better.

Dr. John Fessenden, a general surgeon with Pinehurst Surg-ical, operated on Wright at Moore Regional. He says anti-reflux surgery has a success rate of 80 to 90 percent in eliminating severe heartburn, but it is generally less effective in treating hoarseness and laryngitis.

"That is because the voice problems may not be associated with reflux, or at least not completely," Fessenden says. "I tell patients who have coughing or voice changes that there is a 60 to 65 percent chance of anti-reflux surgery fixing their problem, because there are often other causes such as post-nasal drip."

The Esophageal Center's general surgeons and ENT (ear, nose and throat) physicians frequently consult with each other to determine whether patients with chronic hoarseness or laryngitis can best be helped by anti-reflux surgery or ENT procedures.

Patients who are referred to the Esophageal Center because of acid reflux typically have a battery of tests to find out exactly what their problem is, what is causing it and which treatment option is likely to be most effective.

In addition to physicians who specialize in gastroenterology, ENT and general surgery, the Esophageal Center's staff includes speech-language pathologists.

"The Esophageal Center is a wonderful resource in this region," Fessenden says. "If I had to individually schedule each of the tests that I require before doing an operation, it could take four to eight weeks. But with the multidisciplinary approach at the Esophageal Center, all of the tests can be done quickly, and I can typically have a patient's full assessment in two to three weeks."