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Heartburn

What is Gastroesophageal Reflux Disease (GERD)?

During normal ingestion and digestion, food travels from the mouth through a tube of muscle called the esophagus to the stomach, where it remains until it is pushed into the intestine. Muscles in the lower part of the esophagus just above the stomach, called the lower esophageal sphincter (LES), tighten to keep food and digestive acid in the stomach. In people with gastroesophageal reflux disease, these muscles loosen and allow acid to escape (reflux) into the esophagus, the sensitive lining of which is then damaged or burned.

Prolonged acid reflux, known as gastroesophageal reflux disease (GERD), reduces the LES’ ability to contract, causing acid to remain in the esophagus longer and leading to extended burning. This in turn causes scarring, nerve damage, tightening of the esophagus, the formation of ulcers, and bleeding.

What are the symptoms of GERD?

The most common symptom is heartburn, the burning sensation felt in the center of the chest when acid and partially digested food move from the stomach to the esophagus. Other signs that you may have GERD include:

  • Belching
  • Regurgitation of food
  • Nausea and vomiting
  • Vomiting blood
  • Hoarseness or change in voice
  • Sore throat
  • Difficulty swallowing
  • Coughing or wheezing

When is heartburn worrisome?

Heartburn affects almost everyone at some point in their lives. Heartburn that is experienced several times in a 24-hour period, that occurs many times a month, or that causes hoarseness, coughing, bleeding or swallowing difficulties, is not normal and should be examined.

What are the preventative treatments for GERD and heartburn?

Preventative and non-surgical treatments for acid reflux include:

  • Diet modification
  • Cessation of smoking and alcohol consumption
  • Examination of medications for caffeine, alcohol, etc.
  • Loss of excess weight
  • Avoidance of tight clothing and frequent bending
  • Sleeping with the head of the bed elevated

Are medications helpful?

Medications are typically prescribed when preventative measures prove ineffective, before surgery is recommended. The most common types of medication are H-2 blockers (Axid, Pepcid, Tagamet, Zantac), drugs that increase peristalsis and tighten the LES (Reglan) and proton pump inhibitors (Prevacid or Prilosec).

What are the tests for GERD?

Testing for the presence of GERD include barium “swallow” (upper GI), esophagogastric duodenoscopy, esophageal manometry and pH probe.

What is involved in laparoscopic surgery for GERD correction?

Surgery to correct GERD is called gastroesophageal fundoplication, or stomach wrap. In a two-hour, minimally invasive procedure performed under general anesthesia, the top of the stomach is wrapped gently around the esophagus to imitate normal LES pressure. Laparoscopy, which involves the insertion of a thin tube with a camera on the end so the surgeon can see inside the body and operate without the need for a large or “open” incision, allows for small incisions (¼ to ½ inch), shorter recovery time and less post-operative pain.

How long does recovery take?

Patients usually return home in a day or two and can resume normal activities within a week.

How long before results are appreciated?

Heartburn should end immediately after surgery.

What are the risks and complications?

Many patients experience difficulty in swallowing for one to three weeks following surgery. Risks include injury to the nearby major organs (spleen, liver, esophagus, stomach), bleeding, infection, splenectomy (removal of the spleen), failure to eliminate GERD, prolonged swallowing difficulty, and inability to vomit.

To learn more about our treatments for GERD, please contact us online or call us at 856-673-3288.

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