Reflux Disease GERD
When the stomach acid abnormally flows back into the food pipe, the condition is called as gastro-esophageal reflux disease, or in short, GERD. This acid reflux can irritate the lining of your esophagus, eventually leading to complications like ulcers in the food pipe, precancerous lesions and even cancer of the food pipe. There can be moderate to severe acid reflux at least once a week or mild acid reflux at least twice a week. There are different symptoms of GERD. If changes in your lifestyle and over-the-counter medications cannot give you relief from this problem, you may need surgery.
Treatment
Medications that are commonly used for GERD reflux disease include various classes of antacid tablets and syrups. The role of surgery comes only when patients have severe reflux or those patients who either don’t respond to medical treatment or those who become medication dependent.
Today surgery of GERD is performed by laparoscopy only. Open surgery has become a thing of the past as it used to cause much discomfort to the patient. After laparoscopic surgery patients have a speedy, pain-free recovery and are usually sent home a day after surgery. The procedure that is performed for this disease is called a fundoplication. Patients are evaluated with an endoscopy, pH study of the food pipe and sometimes, a manometry (pressure study) of the food pipe before surgery.
There are various types of laparoscopic fundoplications which fall largely under the groups of complete and partial fundoplications. The most common type of fundoplication is a laparoscopic Nissen’s fundoplication which is a complete fundoplication.
- Laparoscopic Nissen’s fundoplication: The surgeon creates an effective valve mechanism at the bottom of your esophagus to correct gastroesophageal reflux during this surgery. It is also called laparoscopic fundoplication. The surgeon inflates your abdomen with carbon dioxide after making some incisions in your abdomen. It is possible to get a proper operating space in the abdomen by inflating it. Through the incisions, the surgeon inserts the laparoscope and surgical instruments and performs the whole procedure while viewing the picture of the abdomen transmitted by the laparoscope on a video monitor. The procedure involves wrapping up the top part of your stomach around the lower esophageal sphincter. This is done to tighten the muscle and prevent reflux.