What is Reflux?
Gastroesophageal reflux disease (GERD) is more familiar to most people by its other names, heartburn, acid reflux, or acid indigestion. It is a common problem that affects almost one out of every four Americans every month.
Reflux is the term given to acidic digestive juices backing up into the esophagus which is the tube stretching between the stomach and the mouth through which food travels.
Between the stomach and the esophagus is a ring of muscle called the esophageal sphincter or LES. This muscle acts as a one way valve which opens to allow food to pass through it but remains tightly shut at other times to prevent back flow or reflux of stomach content.
While the stomach is designed to cope with its acidic contents, the esophagus is not and the acid irritates the esophageal lining giving the sensation of burning. In chronic cases of untreated gastroesophageal disease, the lining of the esophagus becomes damaged leading to more serious symptoms.
Symptoms of Gastroesophageal Reflux Disease
The most frequently reported symptom of GERD is a burning sensation that starts in the middle of the chest behind the breastbone and moves up toward the throat and neck. In serious cases of GERD, people experience increasingly troublesome symptoms such as difficulty swallowing, dry cough and hoarseness, and occasionally nausea and vomiting. Symptoms are worse after eating and are affected by body position. Exercising, leaning forward, and lying down usually makes symptoms of GERD worse.
Chronic GERD can lead to complications like esophagitis, peptic esophageal ulcer, esophageal stricture, Barrett’s esophagus, and in rare cases esophageal cancer.
Reflux disease is very often associated with a hernia of the stomach up into the chest known as a hiatal hernia. The hernia itself can often cause problems with pain and pressure in the chest. In some cases the stomach slips up into the chest next to the esophagus. This is called a paraesophageal hernia and may put the stomach at risk for injury
For most people, reflux can be prevented or at least the symptoms alleviated by making minor changes in lifestyle and diet or by using prescription medications.
Why Consider Surgery for Gastroesophageal Reflux Disease?
There are a number of reasons for considering a surgical treatment for gastroesophageal reflux disease. Some people do not get complete symptom relief from medications or continue to have symptoms “breaking through” their medical regimens. Young people with GERD often make a decision that they do not want to be on medications for the rest of their lives.
Prolonged medical therapy with medications such as proton pump inhibitors which are commonly prescribed for reflux disease, may lead to complications such as osteoporosis, and many patients are anxious to stop taking these medicines.
Laparoscopic surgery for gastroesophageal reflux disease
The laparoscopic procedure most commonly used to treat gastroesophageal reflux disease is known as a Nissen Fundoplication.
During this procedure any existing hiatal hernia or paraesophageal hernia is repaired and the stomach is brought back into the abdomen. The defect in the diaphragm muscle is repaired. Part of the stomach is used to create a wrap around the top of the stomach at the stomach-esophageal junction. This provides some pressure to the area to prevent acid from refluxing back up into the esophagus.
The procedure works remarkably well and provides significant relief of symptoms in over 95% of patients.
In almost all cases, the surgeons at Surgical Consultants of Hollywood perform this procedure laparoscopically through five very small incisions. Most patients will stay in the hospital for 1-2 days and then return home. Laparoscopic surgery substantially reduces the post surgical discomfort of this procedure most patients feel fully recovered in 7 to 10 days. The reflux goes away almost immediately and most patients wake that first morning after surgery with no reflux at all.
Incisionless Fundoplication Using EsophyX®
Recent advances in natural orifice surgery have introduced the Transesophageal Incisionless Fundoplication or TIF procedure. This procedure is similar to a laparoscopic fundoplication except the entire surgery is performed through the patient’s mouth using a specialized instrument called EsophyX.
With TIF EsophyX, there are no incisions through the abdomen and no dissection of internal organs. This means no visible scars and TIF EsophyX patients report less discomfort than those patients who have open or laparoscopic procedures.
For more information about his remarkable new procedure, visit the TIF EsophyX page.