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.