Reflux Surgery - Solution for Heart Burn

Heartburn is a common problem for Americans. Almost everyone gets heartburn from time to time - some people as often as once a day. However, heartburn that is longstanding, interferes with daily activities and is problematic becomes gastroesophageal reflux disease (GERD) and effects 25 to 30 percent of the population.

Reflux is a normal physiologic function in which stomach acid splashes up into the esophagus. It is intended to help clear the esophagus, a muscular tube that carries food to the stomach, of possible poisons or irritants and to allow vomiting in similar situations. A muscle complex between the stomach and the esophagus the lower esophageal sphincter (LES) plays a major role in preventing unwanted reflux and GERD.

When working properly, the LES opens to allow food in the stomach. Then, it closes to prevent stomach acid from washing back up. In some people, the LES becomes weak, or does not always close properly. When this happens, stomach acid tends to back-up into the esophagus.

Several factors may weaken the LES or increase the amount of acid in the stomach. These include obesity, pregnancy, smoking, alcohol, acidic foods and drinks, caffeine, fatty or spicy foods, peppermint, and lying down or bending over after eating. Other factors contribute to GERD including a weakened diaphragmatic hiatus (hole through the diaphragm allowing transit of the esophagus) and the development of a hiatal hernia as well as delayed gastric emptying and delayed esophageal emptying. The latter two lead to longer exposure of acid to the esophagus and further injury.

GERD can damage the lining of the esophagus. This may lead to esophagitis, or inflammation of the esophagus, scar tissue and strictures, ulcers or the development of Barrett's esophagus. In Barrett's esophagus, the normal cells change into intestinal-type cells in an effort to combat the acidic irritant and protect the esophagus. Unfortunately, some of these cells have the potential to continue changing perhaps into cancer cells. About 11 percent of people with Barrett's esophagus develop esophageal cancer. GERD can also damage the lining of the vocal cords and trachea or breathing tube. People often develop sore throats, hoarseness, or asthma-type symptoms.

Healthy lifestyle choices can often relieve symptoms of reflux. These include rnanaging weight; quitting smoking; determining and avoiding irritants like alcohol and caffeine; eating more frequent, sma11er meals; or waiting three hours after eating before lying down. Over the counter medicines also provide relief. For severe heartburn, a doctor may prescribe more powerful medication such as proton pump inhibitors (PPI) for example omeprazole.

If these attempts to control GERD do not offer relief, some patients may opt for a surgical solution. A laparoscopic procedure is available to correct dysfunction of the lower esophageal sphincter. Called laparoscopic nissen fundoplication, the surgery can free patients from the discomfort and damage caused by GERD, making an ongoing regimen of medication unnecessary.

The surgery is done by using a laparoscope and several instruments. This small telescope allows the doctor to see clearly into the abdomen. During the procedure, the surgeon repairs the hiatal hernia and recreates the LES.

Because the surgery is performed through several small incisions instead of a single long one, there is less pain, a quicker recovery time, a shorter hospital stay, and lower risk of infection.

Please call 410-571-9499 for more information. We will be happy to address your questions and concerns.