GERD/Acid Reflux Surgery

• Incidence: affects 20 percent of the US population.
• Medications: will provide incomplete control of symptoms in up to 40 percent of the patients.
  Long term medications have serious side effects, such as osteoporosis (bone fractures), infections, pneumonia, kidney disease and dementia.
• Anti-reflux surgery provides better relief of GERD symptoms than medications.

A little heartburn is normal, especially after eating foods known to cause it, like spicy foods, citrus or chocolate. However, when it happens frequently, or after eating foods not known to cause heartburn, that could mean a chronic condition known as acid reflux or gastroesophageal acid reflux disease (GERD).

To understand GERD, it’s helpful to know a bit about gastrointestinal anatomy. When eating and drinking, food and liquid pass from the mouth, down the esophagus and into the stomach. The stomach produces strong acid to break down stomach contents before it moves into the small intestines.

Aside from belching or vomiting, the esophagus is mainly a one-way track. The stomach contents are not supposed to go back toward the mouth, and a muscle called the lower esophageal sphincter (LES) closes off the esophagus to prevent that. In GERD, the LES is weakened, allowing food or stomach acid to creep back up the esophagus.

Chronic GERD may affect many parts of your body. The result of the stomach acid creeping back up the esophagus is often that burning sensation in the chest—heartburn. Other symptoms of GERD include:

• Chest pain
• Chronic coughing
• Difficulty swallowing
• Regurgitation of food or liquid
• Sleep disruption
• Lung infections
• Tooth erosion

Over time, the stomach acid can wear away esophageal tissue, potentially causing esophageal ulcers or Barrett’s esophagus, which can increase the risk of esophageal cancer.

Risk factors for developing GERD include:

• Certain medications such as nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin
• Consuming caffeine or alcohol
• Eating Fatty, fried or spicy food
• Hiatal hernia
• Obesity
• Smoking

While there are medications available to treat GERD, surgery has been proven to be a safe and long term more effective option. GERD surgery is safe, effective and a long-term, low-maintenance solution to reduce symptoms and increase your quality of life. There are two main types of surgery: LINX (magnetic sphincter augmentation) and fundoplication.

Advanced Laparoscopic Associates is one of the only surgical practices in New Jersey certified in the revolutionary LINX® Reflux Management System, known simply as LINX. The LINX is a quarter-sized ring of magnetic titanium beads that wraps the esophagus and reinforces the LES.

LINX was approved by the FDA in 2012. It is implanted laparoscopically and boasts a short hospital stay and low rate of complications. Best of all, its short recovery time means an almost immediate improvement in symptoms and a very brief interruption of your daily life.

Fundoplication is an established surgical procedure to strengthen the LES. In the most popular form, known as Nissen fundoplication, surgeons wrap the top part of the stomach—called the fundus—around the bottom of the esophagus and sutures it in place. This reinforces the LES and prevents stomach acid from creeping up the esophagus.

Most Nissen fundoplication procedures are now performed laparoscopically, with small incisions, small tools and a flexible camera called a laparoscope attached to a video monitor. Like LINX, hospital stays are brief, recovery time is short and pain levels are low.

With a Nissen fundoplication, the fundus is wrapped 360 degrees around the esophagus. With some patients, however, this full wrap can cause problems swallowing. These patients may have more success with a partial 270-degree wrap, a procedure known as Toupet fundoplication.

There are medications available to treat GERD. Antacids neutralize stomach acid, while H2 blockers and proton pump inhibitors (PPIs) decrease the amount of stomach acid produced.

However, medications have drawbacks. They treat the symptoms as opposed to the root cause of LES relaxation, and most must be taken for life. Some cause side effects—antacids can cause diarrhea and constipation. PPIs, while generally considered more effective than H2 blockers, put people at greater risk of fractures, chronic kidney disease and early death.

If you have tried medication to control your GERD and found it to be ineffective, request an appointment with one of our surgeons today. We will discuss options to surgically treat your GERD, come up with a treatment plan that’s right for you, and be with you every step of the way, from the initial consultation to aftercare and beyond.