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Gastroesophageal
Reflux Disease
What is GERD?
Gastroesophageal reflux disease (GERD) is a digestive disorder that
is caused by gastric acid flowing from the stomach into the
esophagus. This reflux occurs when the lower esophageal sphincter
(LES) opens spontaneously, for varying periods of time, or does not
close properly. If left untreated, gastroesophageal reflux can cause
esophageal ulcers, Barretts esophagus and narrowing of the esophagus
(peptic stricture).
What are the symptoms of GERD?
The main
symptom of GERD in adults is frequent heartburn, also called acid
indigestion, a burning-type pain in the lower part of the mid-chest
and upper abdomen. Symptoms of regurgitation and belching are also
very common. Atypical symptoms such as a chronic dry cough, asthma
symptoms, or trouble swallowing may be present without heartburn.
What is a hiatal
hernia?
A hiatal
hernia is caused by an opening in the diaphragm, a flat muscle that
separates the chest from the abdomen, allowing a portion of the
stomach to protrude into the chest. This condition can then cause
the LES to fail and can make GERD and the symptoms worse.
What are the medical treatments available?
The most
common treatment options include lifestyle changes as well as
modifying your diet. In consultation with a doctor, many medications
are available for treating the symptoms of GERD. Some such as
antacids are over the counter, where others may require a
prescription.
When is surgery
indicated for the treatment of GERD?
Surgery is
an option when medicine and lifestyle changes do not help to manage
GERD symptoms. Surgery may also be a reasonable alternative to a
lifetime of drugs and discomfort. Additionally, a large hiatal
hernia can cause symptoms that may require surgery to repair. An
anti-reflux procedure called Nissen Fundoplication is the most
common procedure performed. |
What is the Nissen
Fundoplication?
During the Nissen fundoplication, the
upper part of the stomach is wrapped around the LES to strengthen
the sphincter, prevent acid reflux, and repair a hiatal hernia.
How is it
performed?
The Nissen fundoplication is usually
performed using laparoscopic techniques through tiny incisions(up to
half an inch) in the abdomen. Patients can usually leave the
hospital in 1 to 3 days and can return to work in 2 to 3 weeks.
What is the success
rate for this surgery?
The success rate for the minimally
invasive surgery is 90 to 95 percent for patients who have the
typical symptoms of GERD, such as heartburn, regurgitation, or
belching. For those whose with less typical symptoms, including
hoarseness and chronic cough, the surgery is about 70 to 80 percent
effective at relieving their symptoms.
For more information on GERD and its laparoscopic repair or to
schedule an appontment please
contact us. |