Anti-Reflux Surgery

Anti-Reflux Surgery

Anti-reflux surgery is surgery to correct a problem with the muscles at the bottom of the esophagus. Problems with these muscles allow Gastro Esophageal Reflux Disease (GERD) to happen. GERD is a condition that causes food or stomach acid to come back up from stomach into esophagus. Normally, the contents of stomach are prevented from moving up into esophagus by a ring of muscle called the lower esophageal sphincter. This acts as a one-way valve; if this valve is not working properly, stomach acid is able to rise up into esophagus.

GERD Symptoms

  • A burning sensation in the chest (heartburn), sometimes spreading to the throat, along with a sour taste in the mouth
  • Chest pain
  • Difficulty swallowing (dysphagia)
  • Dry cough
  • Hoarseness or sore throat
  • Regurgitation of food or sour liquid (acid reflux)
  • Sensation of a lump in the throat

Frequent reflux and heartburn may cause inflammation and ulceration of esophagus. It may need to be treated by your doctor. Only your doctor can tell you if your reflux is damaging your esophagus.

GERD Causes

No one knows the exact cause of gastro esophageal reflux. The following are contributing factors that weaken or relax the lower esophageal sphincter, making reflux worse:

  • Lifestyle: Use of alcohol or cigarettes, obesity, poor posture (slouching)
  • Medications: Calcium channel blockers, theophylline, nitrates, antihistamines
  • Diet: Fatty and fried foods, chocolate, garlic and onions, drinks with caffeine, acid foods such as citrus fruits and tomatoes, spicy foods, mint flavorings
  • Eating habits: Eating large meals, eating soon before bedtime
  • Other medical conditions: hernia, pregnancy, diabetes, rapid weight gain

A hiatal hernia occurs when the natural opening in diaphragm from esophagus is too large. Diaphragm is the strong muscle that separates the organs of the chest from those of the abdomen. Stomach may bulge through this opening into chest. This bulging is called a hiatal hernia. It may make GERD symptoms worse.

GERD Treatment

Goals of treatment are reducing reflux, relieving symptoms, and preventing damage to the esophagus. If self-care and treatment with nonprescription medication does not work, your health care professional likely will prescribe one of a class of stronger antacids. This therapy may be needed only for a short time or over a longer period while you make gradual changes in your lifestyle.

GERD Surgery

Surgery is never the first option for treating GERD. Changes in lifestyle, diet, and habits, nonprescription antacids, and prescription medications all must be tried before resorting to surgery. Only if all else fails is surgery recommended. Because lifestyle changes and medications work well in most people, surgery is done on only a small number of people.
Surgery is done while you are under general anesthesia (asleep and pain-free). Surgery usually takes 2 - 3 hours.
Ways your doctor may do this surgery are:

  • Open repair. Your surgeon will make a surgical cut in your belly area (abdomen). Sometimes the surgeon will place a tube from your stomach through the abdomen wall to keep your stomach in place. This tube will be removed when you no longer need it.
  • Laparoscopic repair: Your surgeon will make 3 - 5 small cuts in your belly. Your surgeon will insert a laparoscope (a thin, hollow tube with a tiny camera on the end) through one of these cuts and other tools through the other cuts. The laparoscope is connected to a video monitor in the operating room that allows your surgeon to see inside your belly and do the repair. The surgeon may need to switch to an open procedure if there is bleeding, a lot of scar tissue from earlier surgeries, or you are very overweight.

Endoluminal fundoplication is a new procedure that is done to help prevent reflux. It uses a special camera on a flexible tool called an endoscope that is passed down through your mouth and into your esophagus.
Your doctor will place small clips on the inside where the esophagus meets the stomach. These clips help prevent food or stomach acid from backing up.