Reflux OR Heartburn

Gastro-Esophageal Reflux Disease (GERD)

Most often referred to as heartburn or reflux, GERD represents the advanced stages of chronic heartburn. It is common and not serious to have occasional heartburn, once or twice a week, specially brought on by spicy foods, alcohol or lots of caffeine. However when heartburn becomes daily, chronic and severe it represents a serious health problem referred to as GERD.

There is a valve at the lower end of our esophagus or swallowing tube that is supposed to close after swallowing. This valve prevents food and acid from coming back up or refluxing into the esophagus, throat and mouth. It is referred to as the Lower Esophageal Sphincter (LES). When the LES gets weak or ruined, often caused by a hiatal hernia, it allows acid and food to reflux. This chronic heartburn and regurgitation not only causes burning, bitterness and pain but leads to damage of the esophagus. This damage can include ulceration, bleeding and scarring of the esophagus and over the years may lead to esophageal cancer.

When heartburn is mild and short term it can be successfully treated with medications that either neutralize the acid (Maalox, Mylanta, Tums, Rolaids) or stop the stomach from making acid (Pepcid, Nexium, Aciphex, etc). These medications decrease the burning and pain but do not fix the problem and in many patients stop being effective in the long term. There is also new information that long term use of these medications may have negative consequences.

Fortunately there is a simple laparoscopic surgical procedure that can repair associated hiatal hernias and reinforce the LES with a new valve created using the patient’s own stomach. This procedure is called a Fundoplication often known as a Nissen or Toupet procedure.

Since the procedure is done laparoscopically with four small incisions it has a very fast recovery and very low complication rate. It can often be done as an outpatient and normal activities can be resumed in a couple of days.

In our GERD program we have performed hundreds of laparoscopic fundoplications with most patients eliminating their reflux without further need of medication.

This procedure is ideally suited for patients with several years of using medications to control chronic heartburn.

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