Anti Acid Reflux Surgery

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Anti Acid-Reflux Surgery


Gastroesophageal Reflux Disease (GORD)

Gastroesophageal Reflux Disease (GORD), also known as chronic acid reflux, refers to the upward movement of stomach acid into the oesophagus. This condition typically arises due to a defect or weakness in the Lower Oesophageal Sphincter (LOS), a circular muscle acting as a valve between the oesophagus and stomach contents.

Understanding GORD


Occasional acid reflux is common; however, when it occurs several times a week for months, it is classified as GORD.

Symptoms of GORD


The sensitive lining of the oesophagus is easily irritated by stomach acid, causing a range of symptoms :

  • Burning sensation in the chest
  • Chest pain (often mistaken for a heart attack)
  • Halitosis
  • Sore throat
  • Chronic cough
  • Upset stomach
  • Tooth discolouration

In some cases, symptoms may be absent, known as silent GORD. Regardless of symptom severity, the damage caused by stomach acid can lead to Barrett’s Oesophagus—a pre-cancerous condition marked by cellular changes in the oesophageal lining. The increasing incidence of oesophageal cancer has been linked to the rise in chronic acid reflux, often associated with obesity.

Hiatal Hernias and GORD


Hiatal hernias occur when part of the stomach pushes through the diaphragm into the chest. These hernias are a common cause of GORD, especially in patients with obesity. Hiatal hernias are often detected during preoperative testing for weight-loss surgeries or during the procedures themselves. In many cases, the hernia is repaired concurrently with bariatric surgery.

Diagnosis

Hiatus hernias are typically diagnosed using the following methods :

  • Barium Swallow X-ray :  Provides an image of the oesophagus and stomach to identify abnormalities.
  • Endoscopy :  Allows direct visualization of the oesophagus and stomach.
  • Esophageal Manometry :  Measures pressure and movement in the oesophagus.
  • pH Monitoring :  Evaluates acid levels in the oesophagus to detect GER

Treatments for Chronic Acid Reflux


Lifestyle Changes

  • Adopting a healthier diet
  • Regular exercise to promote weight loss
  • Avoiding high-fat, acidic, or spicy foods
  • Stop smoking and avoid excessive alcohol intake

Medications


  • Proton pump inhibitors (PPIs) :  Suppress stomach acid production
  • Antacids :  Neutralize existing stomach acid

Surgical Interventions


When lifestyle modifications and medications are insufficient or undesirable for long-term management, surgery becomes an option.

Laparoscopic Anti-Reflux Surgery and Fundoplication


(1) The stomach is brought back into its normal position.
(2) The top portion of the stomach is wrapped around the lower oesophagus and sutured, creating pressure to keep the LOS closed and prevent acid reflux.
(3) The diaphragm’s opening (hiatus) is repaired if a hiatal hernia is present.

Variations of fundoplication include :

  • Complete wrap (Nissen)
  • Partial wrap (Toupet)
  • Anterior wrap

Recovery typically involves a puréed diet for several weeks due to postoperative swelling, after which normal eating resumes.
GORD is a manageable condition with proper treatment and lifestyle adjustments. Early intervention is crucial to prevent long-term complications.

Schedule a Consultation


If you suspect you have symptoms of GORD, we encourage you to schedule an appointment. Mr Parmar will provide a comprehensive evaluation and discuss the most suitable treatment options for your condition.