Severe GERD And its Surgery, Laparoscopic Fundoplication
Gastroesophageal reflux disease (GERD) is a chronic condition characterized by frequent acid reflux, the backflow of stomach acid into the esophagus. This can cause symptoms such as heartburn, chest pain, and regurgitation. For those who suffer from severe GERD, it can have a significant impact on their quality of life. Treating severe GERD is critical to preventing complications and improving daily function. An effective surgical treatment for severe GERD is laparoscopic fundoplication.
What is severe GERD?
Definition and symptoms
Severe GERD occurs when acid reflux symptoms are frequent and intense, interfering with daily activities and sleep. Symptoms of severe GERD include :
- Persistent heartburn
- Regurgitation of food or acid
- Difficulty swallowing
- Chest pain
- Chronic cough or hoarseness
- Causes and risk factors
Severe GERD can be caused by
- A weakened lower esophageal sphincter (LES)
- Hiatal hernia
- Obesity
- Cigarette smoking
- pregnancy
certain medications (e.g., NSAIDs, blood pressure medicine)
Diagnosing Severe GERD
Diagnostic tests and procedures
An accurate diagnosis is essential for effective treatment. Common diagnostic tests include
- Endoscopy: A flexible tube with a camera is inserted into the esophagus to look for inflammation and other abnormalities.
- pH monitoring: Measures the frequency and duration of acid reflux episodes.
- Esophageal manometry: Assesses the function of the esophagus and LES.
Importance of accurate diagnosis
Accurate diagnosis helps tailor the treatment plan to the patient’s specific needs, ensuring better management of GERD symptoms and prevention of complications.
Treatment Options for Severe GERD
Lifestyle changes and medications
Initial treatments for severe GERD often include lifestyle changes and medications:
Lifestyle changes: Weight loss, dietary changes, avoiding triggers (e.g., spicy foods, caffeine), and elevating the head of the bed.
Medications: Antacids, H2 blockers, proton pump inhibitors (PPIs), and prokinetics.
When surgery is recommended
Surgery is recommended for patients who do not respond to lifestyle changes and medications, or who have complications such as esophagitis, Barrett’s esophagus, or strictures.
What is Laparoscopic Fundoplication?
Detailed explanation of the procedure
Laparoscopic fundoplication is a minimally invasive surgery in which the upper part of the stomach (the fundus) is wrapped around the lower esophagus to strengthen the LES and prevent acid reflux. Types of fundoplication include
- Nissen fundoplication: The fundus is wrapped 360 degrees around the esophagus.
- Toupet fundoplication: The fundus is wrapped 270 degrees around the esophagus.
Benefits of Laparoscopic Fundoplication
Effectiveness in relieving GERD symptoms
Laparoscopic fundoplication is highly effective in relieving GERD symptoms, with many patients experiencing significant improvements in their quality of life.
Long-term results and success rates
The procedure has high success rates, with 85-90% of patients experiencing long-term relief from GERD symptoms. It also reduces the need for ongoing medication.
Risks and complications:
Potential risks and side effects
Although laparoscopic fundoplication is generally safe, potential risks and side effects include
- Difficulty swallowing (dysphagia)
Gas and bloating
Inability to burp or vomit
Infection or bleeding
How to minimize risks
To minimize risks, choose an experienced surgeon, follow preoperative and postoperative care instructions, and maintain a healthy lifestyle after surgery.
When to Consider Laparoscopic Fundoplication
Criteria for surgical intervention
Patients for laparoscopic fundoplication typically include those who
Have severe, chronic GERD
Are not responding to medications and lifestyle changes
Have complications such as esophagitis or Barrett’s esophagus
If you are struggling with severe GERD, don’t wait. Schedule a consultation with Dr. Apoorva Kulkarni today to discuss your symptoms and learn more about laparoscopic fundoplication. Take the first step toward a life free from the discomfort of GERD.
Severe GERD can significantly impact your quality of life, but effective treatments are available. Laparoscopic fundoplication is a proven surgical option for those who do not respond to other treatments. If you suffer from severe GERD, consider speaking with Dr. Apoorva Kulkarni, an expert in GERD treatment and surgery, to explore your options and improve your quality of life.