|We specialize in minimally
invasive surgery including:
Esophageal Myotomy for Achalasia
General Surgical service for
treatment of the following:
Lower Extremity Venous Disease
What is GERD?
GERD stands for Gastroesophageal Reflux Disease. There is a muscle, acting as a valve, located between the stomach and esophagus. This valve keeps the stomach's contents from "refluxing" back into the esophagus. In patients with GERD, this valve leaks. The stomach's contents are acidic, so when reflux occurs, it literally burns the esophagus.
Is GERD common?
GERD is extremely common. 44% of Americans have heartburn on a monthly basis. 10% have daily symptoms. $5 billion per year is spent on pharmaceuticals.
Is GERD dangerous?
GERD can be dangerous. The stomach has a lining which protects it from its acidic contents, the esophagus does not. When reflux occurs, the esophagus first becomes irritated and inflamed, known as esophagitis. This can progress to ulcerations and bleeding. Strictures, or a narrowing, can follow. Over years of reflux, esophageal cancer can develop.
What are the symptoms of GERD?
Heartburn: a searing sensation in the upper abdomen or chest.
Regurgitation: a sour or bitter taste in the mouth.
Dysphagia: difficulty swallowing.
There are other less common symptoms including asthma, chronic cough, pneumonia, tooth decay, and gingivitis.
Can my lifestyle make reflux more likely or worsen it?
Some foods cause the valve between the esophagus and stomach to weaken or relax. Other foods cause an increase in acid production in the stomach. Caffeine, spicy foods, chocolate, fried and fatty foods are a few of the most common offenders. Alcohol and nicotine also worsen reflux. Obesity is strongly associated with GERD.
Are medications effective at treating GERD?
Medications are the first line of treatment for GERD. These drugs work by either neutralizing the acid or by preventing the acid from being formed in the first place. They are usually very effective at controlling mild symptoms. However, there are drawbacks. These medications are quite expensive, there are side effects, and they must be taken for life. The other downside is that the reflux is still occurring.
What is a hiatal hernia?
The esophagus passes from the chest into the abdomen through an opening in the diaphragm called the hiatus. If this opening is too big, a hernia can result - the stomach bulges into the chest. There is an association between hiatal hernias and GERD.
Is there a surgery that eliminates GERD?
Surgery to prevent GERD was first performed in the 1950s. Today it is routinely done laparoscopically through 5 small incisions. The purpose of the surgery is to reestablish the antireflux barrier - a new "valve" is created. The most commonly performed procedure is known as a Nissen fundoplication. If a hiatal hernia is present, it will be repaired.
How do I know if I am a candidate for surgery?
An extensive workup is done by a gastroenterologist. This includes an endoscopy, barium swallow, 24 hour pH probe, and manometry. These tests will determine if you will benefit from surgery.
What is the usual postoperative course?
Patients spend 1-2 nights in the hospital. On the day following surgery, a liquid diet is started. This is advanced to a soft diet, which patients remain on for several weeks. Following this, a regular diet is resumed. Patients are back to their normal activity in 1-2 weeks.
Do I have to make any changes to my diet following surgery?
Following reflux surgery, patients need to eat slower and chew food more thoroughly. Carbonated beverages must be avoided for about 6 weeks.