About Gastroesophageal Reflux Disease (GERD)
GERD is a common cause of heartburn. The condition causes stomach acids to reflux (back-up) from the stomach into the esophagus. Symptoms include an intense, burning sensation in the area between your ribs and just below your neck. The feeling may radiate throughout the chest and into the throat and neck. Some adults experience these symptoms as often as twice a month. Other more intense symptoms include vomiting, difficulty swallowing, and chronic cough.
Food travels from your mouth through your stomach through a tube called the esophagus. At the lower end of the esophagus is a ring-shaped muscle called the lower esophageal sphincter (LES). The LES functions as a one-way valve that allows food to pass to the stomach.Normally, the LES closes immediately after swallowing to prevent backed-up stomach juices, which have high acidic content. In cases where the LES malfunctions, heartburn and esophageal damage may occur. Some people are born with a naturally weak sphincter. Other causes are related to diet, medication, tight clothing, smoking, alcohol consumption, vigorous exercise, and changes in body position. A hiatal hernia (another common term for GERD) may be present without causing heartburn symptoms.
GERD Treatment Options
GERD treatment requires multiple steps:
Dietary changes and over-the-counter antacids may reduce the frequency and severity of heartburn symptoms. Losing weight, eliminating smoking and alcohol consumption, modifying eating habits, and changing sleeping patterns may also be effective options.
If lifestyle changes are unsuccessful, drug therapy may help. An antacid regimen will neutralize stomach acids and relieve symptoms. If over-the-counter medications are no effective, your doctor may prescribe a stronger drug. Your Houston surgeon will help you develop a highly personalized treatment plan.
Acid Reflux Surgery
Surgery may be the best option for patients who do not respond well to lifestyle changes or medications. Acid reflux surgery tends to have positive outcomes for GERD patients. New techniques called Intraluminal Endoscopic Procedures are alternatives to laparoscopic and open surgery. Schedule an appointment to see whether you are a candidate for any of these options.
The Laproscopic Acid Reflux Surgery Process
Laparoscopic acid reflux surgery (commonly referred to as Laparoscopic Nissen Fundoplication) involves strengthening the “valve” between the esophagus and the stomach by wrapping the upper portion of the stomach around the lowest portion of the esophagus.
In a laparoscopic procedure, surgeons use quarter to half-inch incisions to enter the abdomen using cannulas (narrow tube-like instruments). The laparoscope, which is connected to a tiny video camera, is inserted through the small incision, giving the surgeon an enlarged view of the patient’s internal organs on a television screen. The entire operation is performed within the abdomen.
- Your Houston surgeon will review the risks and benefits of the operation, and you will need to provide a written consent.
- You may need blood work, a medical evaluation, chest X-ray, and an EKG depending on your age and health history.
- Your Houston surgeon may require you to cleanse your colon and intestines prior to surgery. You may need to follow a clear liquid diet for several days prior to your surgery.
- You should shower the night before or morning of your operation.
- You should not eat or drink anything after midnight before your operation.
- Drugs such as aspirin, blood thinners, anti-inflammatory medications (arthritis medications), and Vitamin E may need to be stopped temporarily for up to a week before surgery.
- Diet medication and St. John’s Wort should not be used for two weeks before surgery.
- You will need to quit smoking and arrange for any help you will need at home.
- You’ll arrive at the hospital in the morning.
- A licensed medical staff member will place a needle and catheter in your vein to dispense medication.
- You may need to take a pre-operative medication.
- You will be under general anesthesia and asleep during the procedure, which may last several hours.
- After the procedure, you will be sent to the surgery center recovery room until you are fully awake.
- You may need to spend at least one night or several days in the hospital.
- After surgery, patients are encouraged to engage in light exercise.
- Post-operative pain tends to be mild; however, some patients will need prescription pain medications.
- Acid reflux medication is typically not necessary after surgery.
- You may need to modify your diet after surgery. A liquid diet may be necessary until you are ready to advance to solid foods.
- Within a short period of time, you will be able to resume regular activities such as showering, driving, walking up stairs, lifting, working, and engaging in sexual intercourse.
- You will need to schedule a follow-up appointment within 2 weeks after your surgery.
Benefits of Laproscopic Acid Reflux Surgery
Laparoscopic acid reflex surgery is a minimally invasive procedure with positive patient outcomes. Advantages include reduced postoperative pain, shorter hospital stays, faster return to work, and improve cosmetic results.
Keep in mind, however, that laparoscopic surgery is not for everyone. Make sure that you obtain a thorough medical evaluation from a Houston surgeon who is highly qualified with this procedure. Make sure to involve both your primary care physician and gastroesterologist.