Acid Reflux/GERD Surgery
Acid reflux, also known as gastroesophageal reflux disease or GERD, is a condition that affects millions of Americans. Acid reflux is simply the acidic contents of the stomach moving up into esophagus and irritating its sensitive lining. Thirty percent of the population has a bout with acid reflux, which is perfectly normal after a particularly heavy meal, for example. However, when the acid reflux becomes chronic, it is classified as GERD and should be treated.
Beyond the uncomfortable sensations that acid reflux can cause, there are several considerations the patient must make to ensure continued health. Chronic acid reflux can inflame the esophagus, causing persistent coughs, and even difficulty eating. GERD can even change the esophagus on a cellular level, known as Barrett’s esophagus, which can lead to esophageal cancer, in rare cases.
Causes of GERD
There are various potential causes of chronic acid reflux. Most of these are due to the dysfunction of the esophageal muscles. Typically, there is a valve that allows food into the stomach but closes after swallowing. A significant cause of dysfunction in this valve is obesity, creating unnecessary upward pressure on stomach, pushing food and gastric juices back into the esophagus. Dietary habits including spicy, high-fat or highly-acidic foods can also create an environment conducive to acid reflux.
Hiatal hernias can also cause the upper portion of the summit to push into the diaphragm, causing acid to reflux. Since this is a common issue with those who are overweight, hiatal hernias are often repaired secondarily during weight loss surgery, for example sleeve gastrectomy and gastric bypass.
Treatment for GERD
Treatment for acid reflux can begin in a conservative manner, by losing weight and modifying diet to exclude acidic and spicy items from the diet. Further, eating well before bedtime and having a smaller dinner may help. Sleeping with the head elevated has also been shown to help with symptoms.
If conservative care does not help, medication may. Patients often begin by using over-the-counter antacids. Unfortunately, these chewable tablets are rarely able to control GERD. Stronger OTC acid suppressant, and alternately, neutralizers, are also widely available.
Surgery to reinforce the esophageal valve is called fundoplication and can be effective for most patients. During the procedure, the upper portion of the stomach is wrapped around the esophagus and stitched in place. This reduces or eliminates the acid pushing back up into the esophagus. The procedure is performed in a minimally invasive manner and requires an overnight stay in the hospital.
New medical devices such as the LINX device are also being approved to treat GERD on a regular basis. As these devices come to market, our practice evaluates them against tried and true methods to see if they will benefit our patients.
Risks and Considerations of GERD Surgery
- GERD surgery usually requires general anesthesia
- All the risks of a minimally invasive surgical procedure, including pain, bleeding and infection
- Dropped lung
- Perforation of the esophagus
These risks are relatively low and can be minimized by a surgeon with significant experience treating this condition. Please contact our office to learn more about the options for treating GERD.