Gastroesophageal Reflux Disease (GERD)

What is gastroesophageal reflux disease (GERD)?

GERD, also known as Gastroesophageal reflux disease or, more commonly, acid reflux, is a digestive disorder that affects the muscular ring connecting the esophagus to the stomach, also known as the lower esophageal sphincter. Normally, the sphincter prevents food from creeping up into the esophagus from the stomach.

A patient diagnosed with GERD, presents with a weakened sphincter muscle, which fails to close tightly, thereby allowing, food and stomach acids to flow back into the esophagus (reflux).  The esophageal lining can become inflamed or irritated due to these acids, causing the burning chest pain, sour taste, or cough that patients suffer from.

What is anti-reflux surgery?

Some patients do not respond well to medications or lifestyle changes while others are not comfortable following an on-going medication regimen.  These patients, are candidates  for a surgical procedure to correct their GERD symptoms. The most common surgical procedure for GERD is called a Nissen fundoplication, which involves the repair of a hiatal hernia, if present, and wrapping the top part of the stomach around the end of the esophagus. This recreates a one way valve prohibiting stomach acid from entering the esophagus, and can be done using a minimally invasive technique with several small incisions (laparoscopic surgery). By performing the surgery laparoscopically, the benefits include less pain, a shorter hospital stay, faster recovery, smaller scars, and a reduced risk of infections and hernias.** Laparoscopic anti-reflux surgery is best for those who have not had abdominal surgery previously, those who experience small hiatal hernias without GERD complications, and those who have most of the symptoms of reflux when lying down.

When is GERD or acid reflux surgery necessary?

Those with severe, chronic esophageal acid reflux may need surgery to correct the problem if other medical treatments are not relieving their symptoms. Esophageal reflux can cause further complications including esophagitis, esophageal ulcers, bleeding, scarring of the esophagus, and precancerous changes to the esophagus (Barrett’s) that can progress to esophageal cancer.

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