Anti Reflux (GERD Surgery) - Reason, Symptoms and New Treatments

Anti Reflux (Gerd Surgery) - Reason, Symptoms and New Treatments

The digestive disorder where stomach acids reflux or back up into the esophagus(tube connecting your mouth and stomach) from the stomach. 

Acid reflux is the pain in the lower chest area, commonly known as heartburn. Chronic heartburn can lead to severe complications. Heartburn is considered as a harsh, burning sensation between your ribs and below the neck. 


This sensation may radiate from the chest and into the throat and neck. Other symptoms may include vomiting, difficulty swallowing and chronic coughing.  

When acid reflux happens more frequently, it is known as GERD. Many people try to manage the discomfort of GERD with home remedies and lifestyle changes. 

Unfortunately, most of the people are not helped by medication or later changes and surgery is the best treatment for them. Anti-reflux is the treatment for GERD. Before looking at the treatment, let us know what are the reasons and symptoms of GERD.



Some Basic Facts About GERD

  • There can be serious damage when the stomach acid that goes back into the esophagus.
  • GERD may be the result of a dysfunctional valve at the top of the stomach and bottom of the esophagus. 
  • GERD can be reduced by maintaining a healthy weight, reducing stress and no smoking. 
  • Along with lifestyle changes, protein pump inhibitors and antacids may treat GERD.

What are the causes of GERD?

During swallowing, a circular band of muscle around the bottom of esophagus (called lower esophageal sphincter) relaxes to allow the food and liquid to go ahead into your stomach. After then this sphincter closes again.

When this sphincter relaxes abnormally or becomes weak, stomach acid can flow back into your esophagus. This makes the esophagus inflamed causing heartburn. 



Occasional acid reflux is quite common which usually happens after overeating, lying down after eating or eating a particular food. GERD can happen to people of any age and mostly occurs when people are:

  1. Obese because of increased pressure of the abdomen.
  2. Pregnant due to increased pressure in the abdomen.
  3. Taking certain medicined such as asthma medication, sedatives or antidepressants.
  4. Smoking or being exposed to second-hand smoke.
Hiatal hernia raises the risk of GERD where an opening in the diaphragm lets the top of the stomach move up in the chest.

There are certain conditions which may aggravate GERD. They are:
  • Eating large meals or eating late at night.
  • Fatty food may also trigger this problem.
  • Drinking beverages such as drinking alcohol or coffee. 

What are the Symptoms of GERD?

The most common symptoms of GERD is heartburn and bitter liquid to the throat or mouth called Regurgitation.

This combination does not need diagnostic, it is the common characteristic. Some other symptoms are:
Chest pain which is not burning and which radiates to the back. 

#Difficulty in swallowing

#Nausea and vomiting

#Bad breath

#Respiratory problems

#Sensation of a lump in the throat.

Diagnosis of GERD

The doctors perform a physical examination where they also ask about the medical history and your symptoms. 
The doctor performs the following tests.

Upper Endoscopy-

The doctor examines the lining of the esophagus, stomach and first part of the small intestine. 
It also diagnoses the narrowing of esophageal. It is essential to evaluate the possible complications with endoscopy.

Reflux Testing-

There are two methods- wireless pH and 24 hour pH impedance. These methods help the doctor to evaluate your reflux for a particular time. 
This helps the doctor to evaluate the severity of reflux, presence of non-acid reflux and the correlation between your reflux and symptoms. 

Esophageal Manometry-

Esophageal motility or movement is studied which does not diagnose GERD but help the doctor eliminate the other conditions that mimic GERD. 
This is an essential part of the assessment prior to anti-reflux surgery. 

Barium Esophagram-

This is an X-ray procedure which evaluates the injury to the esophagus. 
This makes it easier for the doctor to look for the narrowing in the esophagus. 

Treatment for GERD

The first thing that a doctor recommends is a change in lifestyle and over-the-counter medication or surgery. 
Medications include:
  • Antacids that neutralize stomach acids.
  • It provides quick relief. But this alone does not heal an inflamed esophagus damaged by stomach acid. Also, overuse of some antacids can cause side-effects such as diarrhea or kidney problems. 
  • Medicine to reduce acid production.
  • Medicines that block acid production and treat esophagus.

Surgery Options In GERD

If the medication does not help the patient, the gastroenterologist suggests surgery. 

A surgery is the treatment for GERD. Fundoplication is the procedure which is commonly performed. In this surgery:-

The surgeon repairs the hiatal hernia if it is present which involves tightening the opening in the diaphragm.

It is done with the help of stitches to keep the stomach from bulging upwards through the muscle wall. Sometimes, a mesh is placed in the defect to make it more strong.

Sometimes the doctor wraps the upper part of the stomach around the end of the esophagus with stitches.

It creates pressure at the end of the esophagus, which prevents stomach acid and food to flow back from stomach to the esophagus. 
The surgery is performed under general anesthesia. There may be different techniques depending on the patient condition. 

Open Surgery

The surgeon makes one large incision in the belly and a tube is inserted into the stomach through the abdomen to keep the stomach wall in place. This tube is taken out after a week. 

Laparoscopic surgery

The surgeon makes 2-3 small incisions on the abdomen and a laparoscope is inserted in one of them and other surgical tools through the other incisions.

A laparoscope is a telescope-like instrument used to see the internal organs and perform the operation. The patients who undergo laparoscopic surgery can leave the hospital within 24-48 hours of the surgery. 

The recovery time is short and post-surgery pain is very less as compared to open surgery. 

Endoluminal fundoplication

This is a new procedure that is done without making incisions. A camera on the flexible tube is placed and passed through the mouth to the esophagus. 

The instrument is known as an endoscope. The doctor puts some clips where the esophagus meets the stomach which prevents food and stomach acid from backing up. 

Conclusion:

Acid reflux can cause heartburn and this acid can damage the esophagus by scarring or getting inflamed. The doctors may recommend surgery if your symptoms continue while you are on medication. Your doctor will be able to help you with the type of procedure to treat GERD. Consult your surgeon to know the post-surgery precautions. Regular exercise helps you to return to normal activities after the surgery. Make your health and happiness a priority in life.
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