Gastroesophageal Reflux Disease(GERD)

Gastroesophageal reflux disease (GERD) occurs when gastric acid frequently flows back into the tube called esophagus which connects the mouth and stomach. This backwash can irritate esophagus' lining. GERD is commonly known as acid reflux.

What are the Causes?

Gastroesophageal reflux occurs when the lower esophageal sphincter (LES) is weak or relaxes wrongly. The LES opens during normal digestion to allow food to pass into the stomach and closes to prevent the flow back of food and acidic stomach juices into the esophagus. The severity of such acid refluxes depends on LES dysfunction and the type and amount of fluid brought up from the stomach.

Some foods and beverages can trigger Gastroesophageal reflux and heartburn. Fried or fatty foods, coffee, or alcoholic beverages are a few examples of what causes Gastroesophageal Reflux Disease.

What are the Risk factors?

Studies show that following act as risk factors for Gastroesophageal Acid Refluxes:

  • Smoking
  • Obesity
  • Pregnancy
  • Bulging of the top of the stomach up into the diaphragm (hiatal hernia)

What are Symptoms?

Common signs and symptoms of Gastroesophageal Reflux Disease include:

  • Heartburn - A burning sensation in the chest, mostly after eating
  • Chest pain
  • Difficulty swallowing
  • Regurgitation/backwash of food or sour liquid
  • Sensation of a lump in the throat

Nighttime acid reflux can cause:

  • Chronic cough
  • Laryngitis (inflammation in voicebox)
  • Asthma or worsen it
  • Disrupted sleep

How to Diagnosis?

If you have acid refluxes more than twice a week, you must see a doctor. A doctor can diagnose Gastroesophageal Reflux Disease based on a physical examination and history of signs and symptoms.

At times an endoscopy and other tests are advised.

How to Prevent?

  • Quit smoking
  • Eating healthy food
  • Limiting caffeine intake
  • Maintain a healthy weight

What are the Treatment options?

Although acid reflux is very common, many people experience them, but they could be severe. The discomfort of acid reflux can be cured with lifestyle changes, dietary modifications and over-the-counter medications. But some patients with severe gastroesophageal reflux disease may need stronger medications or surgery to get rid of the symptoms.

Medications:

Antacids that neutralize stomach acid or medications that reduce acid production or those blocking acid production and heal the esophagus can help. Long-term use of antacids, however, can result in side effects, including diarrhea and buildup of magnesium in the body.

Surgery and other procedures:

Gastroesophageal Reflux Disease or acid refluxes can usually be managed with medication. But if medicines don't help or patient wants to avoid long-term medication use, doctor or laparoscopic surgeon may recommend minimally invasive surgery to treat Gastroesophageal reflux disease:

Fundoplication

The laparoscopic surgeon wraps the top of the stomach around the lower esophageal sphincter, to tighten the muscle and prevent reflux. Fundoplication is usually done with a minimally invasive (Key-hole) procedure. The wrapping of the top part of the stomach can be complete or partial

LINX Device

A laparoscopic surgeon can treat Gastroesophageal Reflux Disease by wrapping a ring of tiny magnetic beads called LINX device around the junction of the stomach and esophagus. These beads have strong enough magnetic attraction to keep the junction closed to refluxing acid, but weak enough to allow food to pass through. The Linx device can be implanted using minimally invasive surgery.

Benefit

  • Get relief from symptoms
  • Don’t have to continue anti-acid medicines anymore

Risks & Aftercare

Above mentioned procedures are extremely safe and complications are rare. However, every surgical procedure carries some risks. Before the procedure, Dr. Mir Asif Rehman, General & Laparoscopic surgeon will evaluate medical history and perform a complete physical examination to minimize risks.