By Elizabeth Colsen, MD, General Surgery
Living with gastroesophageal reflux disease (GERD) can be difficult for many people. When tempted to over-indulge, remember to maintain a reasonable amount of self-restraint, eat slowly and not too close to bedtime, and steer clear of your trigger foods. Limit alcohol consumption to one or two drinks because alcohol often irritates GERD symptoms. Replace high-fat, high-sugar foods with lighter, less acidic options, and have your acid reflux medication readily available. Your body will thank you.
What is GERD?
It is caused when the lower part of the esophagus no longer holds the stomach contents in the stomach and it refluxes or backs up into the esophagus. The weak part is called the lower esophageal sphincter (LES). This is normally a one-way valve preventing food from coming back into the esophagus.
Refluxing of stomach contents can cause many different symptoms including stomach pain, burning chest pain (heartburn), difficulty swallowing, the taste of acid in the throat, or even recurrent lung infections.
What contributes to GERD?
It is different for each patient. Some people have troubles with spicy or fatty foods and drinking alcohol. Smoking also makes symptoms worse. A common problem is worsening symptoms after lying down or being in bed – especially after eating.
How is GERD diagnosed?
An upper endoscopy is a procedure where the doctor uses a camera to examine your esophagus and stomach while you are under anesthesia. During an endoscopy, your doctor may take biopsies to see if the acid has caused any damage to your esophagus.
How is GERD treated?
The first line of treatment is lifestyle modifications. These may include changing your diet, losing weight, reducing or quitting smoking, and reducing or abstaining from drinking alcohol.
If that does not work, then your doctor may recommend that you take a prescription medication to reduce the acid in your stomach. When the medications fail to work, or for those that do not wish to continually take medications, surgery may be an option. Prior to surgery, your doctor may order more tests to confirm that you have acid reflux and your esophagus is working.
The goal of surgery for moderate to severe heartburn is to recreate the one-way valve effect so that acid no longer gets into the esophagus. A Nissen Fundoplication is an anti-reflux surgery where part of the stomach is wrapped around the esophagus to recreate a valve. The Nissen creates a true one-way valve so the acid cannot reflux back up.
This operation is usually laparoscopic, using small incisions which offers a short hospital stay. In some patients, however, certain factors may require the surgery to be an open procedure.
Reference: SOCIETY OF AMERICAN GASTROINTESTINAL AND ENDOSCOPIC SURGEONS (SAGES)