Gastroesophageal reflux disease is a common medical condition characterized by abnormal movement of the gastric contents that enters the esophagus. When it causes injury, severe or frequent symptoms, reflux becomes a disease. It may damage the respiratory tract, pharynx or esophagus.
Gastroesophageal reflux disease’s symptoms
The main symptom of the gastroesophageal reflux disease is heartburn. This is described often as regurgitating bitter or sour liquid to the mouth or throat or an uncomfortable fiery feeling in one’s chest. The combination of regurgitation and heartburn is such a common characteristic of the gastroesophageal reflux disease that may be unnecessary to further proceed with more formal testing.
Other symptoms of the gastroesophageal reflux disease include:
• Swallowing difficulty called dysphagia
• Non-burning chest pain located typically in the middle of the chest and radiating to the back
• Atypical reflux symptoms relating to the lungs, larynx or throat:
• Increased salivation
• Sore throat
• Shortness of breath
A diagnosis of GERD starts with a thorough physical examination, during which you describe your symptoms and medical history. If the typical symptoms of reflux disease are present, including heartburn and regurgitation, your doctor may begin treatment without performing specific diagnostic tests.
However, tests may be performed if:
- Your symptoms are atypical
- The severity of the reflux raises concerns about oesophageal damage
- Symptoms do not respond to initial treatment
- Your doctor is considering anti-reflux surgery
Diagnostic procedures for GERD include:
- Upper endoscopy
- Reflux testing (wireless pH/pH impedance)
- Oesophageal manometry
- Barium swallow
If the heartburn is not going away with lifestyle changes and medication, one of the options of treatment is surgery. This is also the recommended treatment approach in case that the patient suffers of:
• Severe inflammation of their esophagus
• Esophagus narrowing not caused by cancer
• A change in the cells due to acid reflux called Barrett’s esophagus
You will probably be asked to get some tests before surgery, in order to check how well your esophagus muscles work. These tests may include oesophageal motility studies and oesophageal manometry.
Because of the risk related to any operation, the option for acid reflux surgery will be chosen only when there is a good chance that the surgery will turn out well and only after other treatment options don’t work.
Usually, the first step of the acid reflux surgery medical procedure is introducing a flexible endoscope tube into your esophagus and stomach through your mouth. The tube features a camera and a light in order to make it possible to see inside your body. Using special tools, tissue samples can be taken through the endoscope.
The endoscope tube comes with a set of small tools at its tip. These tools can be used in order to tightly bind the top of the stomach to the end of the esophagus or to place stitches in the lower esophagus in order to strengthen the area.
Another possible procedure is called the radio-frequency treatment or the Stretta procedure. This involves directing high-energy waves into the lower esophagus’ wall in order to create small amounts of scar tissue. This can usually lessen acid reflux symptoms such as heartburn.
These procedures can often be effective, and their advantage is that they do not require putting you under general anesthesia, cutting into your belly or a hospital stay. However, usually, they do not work as well as the gastroesophageal reflux surgery.
For stubborn heartburn, the main surgery procedure is called fundoplication. This can be open fundoplication when the surgeon is directly touching the parts of your body where he is working on, or special tools can be using to operate on your from the outside. Among these tools is included a laparoscope, a thin tube with a camera and a light.
The surgeon will cut into your abdomen a few small cuts for laparoscopic surgery or one large cut in case of the open surgery. A part or all of the stomach’s top part will be wrapped around your esophagus’ lower part and sewed it in place.
This procedure has the role to tighten the esophagus in order to prevent stomach acid from entering into it. In a case of laparoscopy surgical procedure, you will have less pain and a shorter recovery time. This minimally invasive surgery has also the advantage to not leave a large scar.