Acid Reflux (GERD)

What is Acid Reflux (GERD)?

Gastroesophageal reflux disease (GERD), commonly known as acid reflux, is a chronic condition where stomach acid flows back into the esophagus, causing irritation and discomfort. GERD can lead to more serious health issues if left untreated.

What Causes Acid Reflux (GERD)?

Acid reflux occurs when the lower esophageal sphincter (LES), a valve at the end of the esophagus, fails to function properly. This valve’s role is to prevent stomach contents from flowing back into the esophagus. While occasional reflux is normal and usually symptom-free, chronic reflux can cause serious issues like ulcers, erosion of the esophageal lining, strictures, and severe inflammation. The dysfunction of the LES is often linked to a hiatal hernia, where part of the stomach pushes through an enlarged opening in the diaphragm, weakening the LES. Additionally, certain foods (like peppermint and chocolate), chemicals, and medications (such as antihistamines, calcium channel blockers, and opioids) can further impair the LES, exacerbating acid reflux.

Symptoms of Acid Reflux (GERD):

  • Heartburn: A burning sensation in the chest, often after eating, which might be worse at night.
  • Regurgitation: Sour or bitter-tasting acid backing up into your throat or mouth.
  • Difficulty Swallowing: Feeling like food is stuck in your throat or chest.
  • Chronic Cough: Persistent cough that doesn’t seem to go away.
  • Chest Pain: Sharp or burning pain in the chest, especially after eating.

Treatment Options for Acid Reflux (GERD):

  • Lifestyle Changes: Weight loss, dietary adjustments, and quitting smoking can significantly reduce symptoms.
  • Medications: Over-the-counter antacids, H2 blockers, and proton pump inhibitors (PPIs) can help reduce acid production and heal the esophagus.
  • Surgery: In severe cases, procedures like fundoplication or LINX device implantation may be recommended to strengthen the LES and prevent acid reflux.

Why Consider Surgery for Acid Reflux (GERD)?

Surgery is often considered for GERD patients who:

  • Experience severe, persistent symptoms despite medication and lifestyle changes.
  • Have complications such as esophagitis, Barrett’s esophagus, or strictures.
  • Prefer a long-term solution to avoid continuous medication use.
  • Have a hiatal hernia contributing to their reflux.

Types of Surgical Treatments for Acid Reflux (GERD):

Nissen Fundoplication

Nissen fundoplication is the most common surgical procedure for treating GERD. This minimally invasive surgery involves wrapping the upper part of the stomach around the lower esophageal sphincter (LES) to strengthen it, prevent acid reflux, and repair any hiatal hernia present.

Procedure Details:

  • Performed laparoscopically with small incisions.
  • General anesthesia is used.
  • The surgeon wraps the top of the stomach around the LES.
  • The procedure typically takes 1-2 hours.

Benefits:

  • Significant reduction or elimination of acid reflux symptoms.
  • Repair of hiatal hernia.
  • Minimal scarring and faster recovery due to laparoscopic approach.


LINX Reflux Management System

The LINX system is a less invasive option that involves placing a ring of magnetic beads around the LES. These beads strengthen the sphincter while allowing it to open for swallowing and belching.

Procedure Details:

  • Performed laparoscopically with small incisions.
  • General anesthesia is used.
  • The surgeon places the LINX device around the LES.
  • The procedure typically takes less than an hour.

Benefits:

  • Quick recovery with most patients returning to normal activities within a few days.
  • Reduced dependency on medications.
  • Preservation of normal digestive functions.

 

Transoral Incisionless Fundoplication (TIF)

TIF is a newer, minimally invasive procedure performed through the mouth, avoiding external incisions. This procedure involves creating a valve between the stomach and esophagus to prevent reflux.

Procedure Details:

  • No external incisions required.
  • Performed under general anesthesia.
  • The surgeon uses an endoscope to create a valve at the LES.
  • The procedure typically takes 30-45 minutes.

Benefits:

  • No visible scars.
  • Quick recovery time.
  • Effective reduction of GERD symptoms.

Post-Surgery Recovery and Care

  • Hospital Stay: Most patients stay in the hospital for 1-2 days, depending on the procedure.
  • Dietary Changes: Gradual reintroduction of foods, starting with liquids and progressing to solids.
  • Activity: Patients can typically resume normal activities within a few days to a week, depending on the procedure.
  • Follow-Up: Regular follow-up appointments to monitor recovery and ensure the effectiveness of the surgery.

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