Gastroesophageal
reflux disease (GERD) is a common medical problem made of a constellation of symptoms.
These include heartburn, acid or sour-tasting fluid in the throat and even problems
swallowing. Many of these can be treated successfully with the use of medications but when
symptoms persist or worsen while on medical therapy, surgery may be the best option.GERD
is caused by a laxity of the muscle at the junction of the stomach and esophagus called a
sphincter. This allows acid to roll from the stomach to the esophagus resulting in painful
heartburn. Some foods and drugs, including alcohol, tobacco and caffeine, can make this
laxity worse and therefore cause reflux. The avoidance of these may improve one's symptoms
as can weight loss. The use of antacids and acid-reducing medications can alleviate
heartburn.
Untreated, gastroesophageal reflux can lead to an inflammatory process that can
progress to ulcers and strictures of the esophagus, making it painful or difficult to
swallow.
When medical methods fail, surgery may be indicated. Fundoplication is the
surgical procedure used to reduce the symptoms associated with GERD and can now be
performed with the aid of the laparoscope or videoscope. This surgery aims to reconstruct
or improve the sphincter muscle function at the end of the esophagus. This is accomplished
by wrapping the junction of the stomach and esophagus with the mobilized stomach wrap. In
most cases this can be performed with the videoscope which results in much less pain
postoperatively and allows for a quicker return to work or school. The hiatal hernia, if
present, is repaired by this method as well.
At Advanced Surgical Associates, we evaluate and treat patients with symptoms of
gastroesophageal reflux disease and hiatal hernia with the goal of improving one's
lifestyle and freeing them from the dependence on medications. We believe this
can be done safely by the well-trained surgeon accomplished in advanced laparoscopic
techniques.
