An individual who has GERD experiences a backflow of food and acid from the stomach into the esophagus (reflux), which results in undesirable symptoms. In addition, the stomach acids can damage the esophagus.
What is GERD?
Gastroesophageal reflux disease (GERD) is a disorder affecting the lower esophageal sphincter (LES) that connects the esophagus with the stomach. When the LES is functioning properly, it opens when an individual swallows and closes to prevent the food from re-entering the esophagus once it has reached the stomach.
Reflux occurs when the LES weakens or fails to close tightly enough. When this backflow occurs, the esophagus’ lining may become irritated and/or inflamed. Sometimes, the cause of this LES malfunction is unknown; however, there are some lifestyle and behavioral factors that can contribute to the failure of this valve.
A Hiatal Hernia Could Lead to GERD
When the lower esophageal sphincter moves above the diaphragm, a hiatal hernia is the result. Once the LES moves into the chest, preventing reflux is more difficult.
Symptoms of GERD
A burning sensation in the middle of the lower chest and/or the upper abdomen is the most common symptom of GERD.
Other Symptoms of GERD include:
- a sour taste in the mouth;
- a chronic cough;
- sore throat;
- wheezing; and/or
- repeated throat clearing.
The symptoms associated with GERD can worsen if an esophageal motility disorder or esophageal damage inhibits the clearance of fluid and acid from the distal esophagus.
Initially, lifestyle modifications are recommended; however, if these modifications do not eliminate or decrease the severity of the problem, medication may be necessary. GERD medications include H2-receptor blockers and proton pump inhibitors (PPIs). While these medications may not stop the reflux altogether, they often reduce the amount of acid present in the gastric fluid. Typically, this reduction significantly relieves or eliminates the symptoms associated with GERD. Although these medications are effective, individuals who take PPIs on a regular basis for an extended period of time may increase their risk of osteoporosis.
Non-surgical (lifestyle changes)
Behavioral and lifestyle changes can reduce the symptoms of GERD.
Changes may include:
- avoiding carbonated beverages;
- losing weight;
- reducing caffeine intake;
- decreasing meal sizes;
- switching to a low-fat diet;
- reducing alcohol consumption;
- quitting smoking;
- avoiding foods that may trigger GERD (e.g., acidic foods or spicy foods);
- avoiding foods and beverages for several hours prior to bedtime; as well as
- keeping your head elevated (at least 6 inches) while sleeping.
Antireflux surgery is another option for treating GERD.
Indications for surgery include continuing symptoms despite the implementation of appropriate medical therapy and lifestyle changes. A personal preference, the desire to eliminate the need for lifelong GERD medication and/or severe, chronic esophageal reflux. If chronic reflux is not treated, complications may arise.
What is Antireflux Surgery?
Surgery for GERD is usually performed using a surgical technique called laparoscopy. This minimally invasive procedure can be performed using several small incisions (less than ½ an inch) on the abdominal wall. A narrow tube with a camera on its end (laparoscope) is inserted through one of these incisions. Our Surgeons perform this procedure using several thin, long operating instruments and a monitor displaying a magnified visualization of the patient’s abdominal cavity. During laparoscopic antireflux surgery, a barrier to stop reflux is created. This is accomplished by wrapping a small portion of the stomach around the base of the esophagus as a means to augment, recreate or strengthen the LES valve.
Laparoscopic vs Traditional
Laparoscopic antireflux surgery is a minimally invasive technique requiring several small incisions; whereas, traditional surgery is an open surgery that requires a large 6-inch incision created vertically from the sternum to the navel.
Laparoscopic Surgery for GERD
During laparoscopy, a patient can expect:
- five small incisions to be created in the abdomen;
- carbon dioxide gas to be introduced into the abdomen, which expands the space, providing the Surgeon with a better view; and
- the incisions to be closed with hidden stitches and then bandaged.
Benefits of laparoscopy include a hospital stay that typically lasts just overnight; there is no need for a nasogastric tube, a quick recovery (that lasts approximately a week), minimal bleeding and scarring as well as a low risk of infection. Most importantly, reflux symptoms stop immediately with the surgery.
Traditional Surgery for GERD
During a traditional open surgery, a patient can expect:
- a 6-inch vertical incision to be created (from the sternum to the navel); and
- surgical staples to be used to bring the incision together.
Negative aspects of traditional surgery include a hospital stay that typically lasts for six days, the need for a nasogastric tube, an increased potential for bleeding, a recovery lasting at least six weeks, a large scar on the abdomen and an increased risk of infection.
Benefits of Antireflux Surgery
Surgical outcomes are generally excellent, with the majority of patients reporting a significant relief from their symptoms. Thus, eliminating the need to take medications for GERD and improving their quality of life.
Why Choose The Surgery Group?
At The Surgery Group, we strive to provide patients with the highest quality of care available in and around Northwest Florida. Whenever possible, we lean toward laparoscopic surgery; however, when minimally invasive surgery is not an option, we can perform conventional surgery. Our Board-Certified Surgeons have the skills, experience, and knowledge necessary to perform minimally invasive and robot-assisted procedures as well as traditional open surgeries.
If you have GERD and you are considering antireflux surgery, contact The Surgery Group at 850.444.4777 to schedule an appointment with one of our physicians. We have been serving communities in Northwest Florida and South Alabama for over two decades.