Acid reflux disease, often referred to as GERD (gastroesophageal reflux disease), is an increasingly common digestive complaint. It is characterised by a backflow of stomach acid into the esophagus, causing a burning sensation in the chest.
When acid reflux symptoms such as heartburn become severe and persistent (more than twice a week), they may indicate a case of GERD. GERD can cause serious complications such as esophageal cancer and Barrett’s Syndrome. In this case, surgical procedures may required to treat acid reflux disease.
When are Surgical Procedures Necessary for Acid Reflux Disease?
Medical therapy is the preferred treatment for acid reflux. However, the doctor may recommend surgery in these cases:
- if drug treatment fails to control acid reflux symptoms
- if the sphincter muscle does not work properly
- if the patient wants to avoid long term medication for their acid reflux symptoms
- if chronic acid reflux progresses to esophageal cancer
Nissen Fundoplication
Nissen fundoplication is a surgical procedure that tightens and reinforces the lower esophageal sphincter (LES). In this procedure, the surgeon wraps the upper part of the stomach (called the fundus) around the lower portion of the esophagus so to tighten the lower esophageal sphinters.
Laparoscopic Surgery
Laparoscopic surgery is a minimally invasive procedure, and an alternative to the traditional open surgery technique. Rather than make an incision, the surgeon makes three or four small cuts in the abdomen and inserts instruments, including a flexible tube with a tiny camera to perform the surgery.
EndoCinch Endoluminal Gastroplication
This is a surgical procedure that aims to create a barrier that helps prevent the reflux (back up) of stomach acid into the esophagus. Pairs of sutures are stitched near the weakened sphincters and then tied together to create this barrier. Clinical research is still ongoing on the effectiveness of this procedure.
Stretta System
The Stretta System is a minimally invasive procedure that involves no cutting or suturing. This procedure aims to cauterize the nerves that respond to the refluxed stomach acid. It is performed using an endoscope, which is a thin, flexible tube that is passed down the throat into the esophagus.
A catheter is guided down the endoscope, and the heat from an electrode is used to damage nerves in the esophagus and create scar tissue. As the esophagus heals and scar tissues begin to form, the muscles are also strengthened.
Ongoing Research on Surgical Treatment for Acid Reflux
The use of surgical procedures to treat acid reflux disease is controversial. Clinical studies are raising questions as to whether surgery is more effective than medical therapy and if it actually cures this condition.
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