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Surgery for Acid Reflux

Surgery for Acid Reflux

The common surgical procedure for acid reflux is fundoplication, performed either by laparoscopy or open surgery. In this procedure, the upper stomach portion is wrapped around the lower esophageal portion. There are certain pros and cons of acid reflux surgery, explained in the following HealthHearty article.
Ningthoujam Sandhyarani
Last Updated: Dec 21, 2017
Acid reflux, also known as gastroesophageal reflux disease (GERD), is characterized by an abnormal regurgitation of the stomach liquids into the esophagus. The regurgitated liquids contain acids and pepsin secreted by the stomach for the digestion process. Unlike stomach lining, the mucous lining of the esophagus is very sensitive. Hence, frequent reflux of stomach acids causes inflammation and damage to the esophageal lining, resulting in various symptoms.
Some of the common noticeable symptoms are, difficulty in swallowing, regurgitation, nausea, excessive saliva secretion, chest pain, and heartburn. The major cause of acid reflux is malfunctioning or abnormal relaxation of the lower esophageal sphincter (LES) that acts as a barrier between esophagus, and hence, the stomach does not function properly.
Treatment for Acid Reflux
Mild and occasional heartburn is common, which can be managed by making certain lifestyle changes, especially dietary changes. However, frequent and severe symptoms should be treated before progressing to other complicated medical conditions. After a correct diagnosis, the physician may prescribe medications and other lifestyle changes. In severe cases, when medications and lifestyle modifications are not effective, the doctor may suggest surgical procedure. Surgery may also be a better option for those who require lifelong administration of medications and those having severe damages done to the esophagus.
Information About The Surgery
The commonly practiced surgical procedure is Nissen fundoplication or simply fundoplication. It is usually conducted by minimally invasive, laparoscopy techniques. Very rarely, traditional open surgery is used for performing fundoplication. The long-term health benefits of both the procedures are the same. Nevertheless, one can discuss with a qualified surgeon about the pros and cons of various surgical options. Whatever be the option, the main objective is to repair the lower esophageal sphincter, so as to prevent further acid reflux and irritation in the esophageal lining.
Prior to the fundoplication procedure, the patient is evaluated by using endoscopy for about 24 hours. If the endoscopy results are positive, only then the physician may continue with the procedure. In fundoplication, the fundus or upper stomach portion is wrapped around the lower part of the esophagus, which is then anchored gently below the diaphragm.
If it is performed by laparoscopy, the patient may have to stay overnight in the hospital. This procedure helps in relieving the symptoms of acid reflux by strengthening the esophageal sphincter. In addition, a flap valve (the wrapped esophageal portion) is made immediately before the entering of the stomach. As the wrap portion inflates in a full stomach, the valve is tightened, thus preventing reflux even when the stomach is full. Overall, the surgery helps in restoring the normal pressure necessary for the effective functioning of the LES.
Speaking about the pros of acid reflux surgery, more than 90 percent of the patients get relief from severe heartburn after the surgery. It also promotes the digestive health of the patient by enhancing peristalsis and stomach emptying. Surgical complications are rare (about 2-4 percent) and mostly related to wrapping of the stomach. However, the benefits outweigh the complications and one can undergo the surgery without any hesitation.