Surgery for Acid Reflux

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 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 of acid reflux 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 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 of acid reflux 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 for the treatment of acid reflux. Surgery may also be a better option for those who require lifelong administration of medications and those having severe damages in the esophagus.

Surgery for Acid Reflux

The standard commonly practiced surgical procedure for acid reflux 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 for acid reflux. 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 for fundoplication, then only the physician may continue 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 fundoplication is performed by laparoscopy, the patient may get the discharge the next day after surgery. 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 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, acid reflux surgery helps in restoring the normal pressure necessary for the effective functioning of LES.

Speaking about the pros of acid reflux surgery, more than 90 percent of patients get relief of 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 for those who require surgery for acid reflux.