Gastroesophageal reflux disease (GERD), also known as acid reflux or heartburn, is a condition that affects up to 17 million Americans. It occurs when secretions from the stomach back up or reflux into the esophagus, the tube that connects the mouth to the stomach. The secretions typically have a high concentration of acid and act by irritating and inflaming the esophagus. It typically causes a harsh, burning sensation in the chest or upper abdomen and can radiate throughout the chest or up to the throat. It can cause other symptoms as well including difficulty swallowing, chronic coughing, sour taste, bad breath, vomiting, wheezing and erosion of tooth enamel. Over time, these secretions can cause permanent damage to the esophagus and lead to narrowing or stricture of the esophagus, ulcerations, metaplastic changes (Barrett’s esophagus), and even esophageal cancer.
Normally, a circular band of muscle called the lower esophageal sphincter (LES) acts like a one-way valve and only opens when swallowing. The LES should otherwise remain closed and prevent the back up of any stomach secretions into the esophagus. If the LES becomes weakened or abnormally relaxes, the stomach secretions can reflux up and cause the associated symptoms. These changes in the LES can also be exacerbated by the presence of a hiatal hernia. This occurs when a portion of the stomach protrudes through the diaphragm and goes up into the chest.
Progressive Treatment for GERD
- Lifestyle Changes: Many times, the symptoms of GERD can be reduced by making changes in habits or diet. Weight loss, smoking cessation, decreasing alcohol consumption, dietary modifications, and changing sleep habits can help decrease the symptoms.
- Pharmacotherapy: There are various medications designed to help decrease the symptoms of GERD. Medications such as antacids can help neutralize stomach acid. There are multiple medications available which block the secretion of stomach acid. These can be obtained over the counter and by prescription. This therapy will need to be discussed with your doctor.
- Surgery: Anti-reflux surgery is generally recommended for patients who do not respond well to lifestyle changes or medications, have recurrent symptoms after the medication is stopped, or who are unable to discontinue their medications. It can also be an option if patients are unwilling to stay on long-term medications or if significant damage to the esophagus has already occurred.
Patients are generally evaluated using a combination of upper endoscopy, 24-hour pH studies, manometry and barium X-rays.
Surgeons at Johns Creek Surgery have extensive training in advanced laparoscopic surgery and commonly utilize this technique for bariatric procedures, Nissen fundoplications (reflux), gallbladders, hernias, colons, and many other more complex procedures. Our surgery center treats patients from all over the Metro area including Roswell, Milton, Flowery Branch, Cumming, and Alpharetta. It is equipped with the latest in laparoscopic technology. Your surgeon will be happy to talk with you to see if you are a candidate for a laparoscopic procedure.