Surgery for GERD

During this surgery, called a fundoplication, your lower esophageal sphincter (LES) is re-created by wrapping the top of your stomach around the esophagus. It can sometimes be done with a laparoscope through several small incisions instead of a single long one, as in the traditional open procedure. As a result, there is less pain, a quicker recovery time, a shorter hospital stay, and lower risk of infection.

Lifting the Esophagus

If the opening of the hiatus is too large (hiatal hernia), the doctor may tighten it with a few stitches (sutures). This repairs the hiatal hernia. Then the esophagus is lifted out of the way for a short time

Laparoscopic Surgery

• You will be given anesthesia and any other medications through an intravenous tube (called an IV). You will be asleep during surgery.
• Your abdomen will be inflated with carbon dioxide gas to provide more space for your surgeon to see and work. (The gas is removed at the end of surgery.)
• The laparoscope, which has a camera attached, is then inserted through an incision to send images to a video screen. Small surgical instruments are inserted through other incisions.

Open Surgery

• If your surgeon feels it isn’t safe to continue with a laparoscopic procedure once surgery has started, he or she will complete the operation through a larger incision in your chest or abdomen. This is called an open procedure.
• This surgery requires a longer recovery time, up to 1 week in the hospital and from 4-6 weeks at home.

What Is Acid Reflux?

Do you have to clear your throat or cough often? Are you hoarse? Do you have difficulty swallowing? If you have these or other throat symptoms, you may have acid reflux (when stomach acid washes up and irritates your throat).

Why You Have Throat Symptoms

At both ends of the esophagus (the tube that carries food to the stomach) are the esophageal sphincters. These muscles relax to let food pass, then tighten to keep stomach acid down. When the lower esophageal sphincter (LES) doesn’t tighten enough, acid can reflux from the stomach into the esophagus. This may cause heartburn. If the upper esophageal sphincter (UES) also doesn’t work well, acid can travel higher and enter your throat (pharynx). In many cases, this causes throat symptoms.

Common Throat Symptoms

• Frequent need to clear your throat
• Feeling like you’re choking
• Chronic cough
• Hoarseness
• Trouble swallowing
• Sensation of having “a lump in the throat”
• Sour or acid taste
• Recurrent sore throat

Tips to Control Acid Reflux

To control acid reflux, you’ll need to make some basic diet and lifestyle changes. The simple steps outlined below may be all you’ll need to relieve discomfort.

Watch What You Eat

• Avoid fatty foods and spicy foods.
• Eat fewer acidic foods, such as citrus and tomato-based foods. These can increase symptoms.
• Limit drinking alcohol, caffeine, and fizzy beverages. All increase acid reflux.
• Try limiting chocolate, peppermint, and spearmint. These can worsen acid reflux in some people.

Watch When You Eat

• Avoid lying down for 3 hours after eating.
• Do not snack before going to bed.

Raise Your Head

Raising your head and upper body by 4″ to 6″ helps limit reflux when you’re lying down. Put blocks under the head of the bed frame to raise it.

Other Changes

• Lose weight, if you need to.
• Don’t work out near bedtime.
• Avoid tight-fitting clothes.
• Limit aspirin and ibuprofen.
• Stop smoking.

Your healthcare provider has told you that you have acid reflux. This is a condition that causes stomach acid to wash up into your throat. For most people, acid reflux is troubling but not dangerous. However, left untreated, acid reflux sometimes damages the esophagus. Medications can help control acid reflux and limit your risk of future problems.

Medications for Acid Reflux

Your healthcare provider may prescribe medication to help treat your acid reflux. Medication will be based on your symptoms and the results of any tests. Your healthcare provider will explain how to take your medication. You will also be told about possible side effects.

Reducing Stomach Acid

Your doctor may suggest antacids that you can buy over the counter. Or you may be told to take a type of medication called H2 blockers. These are available over the counter and by prescription (for higher doses).

Blocking Stomach Acid

In more severe cases, your doctor may suggest stronger medications such as proton pump inhibitors (PPIs). These keep the stomach from making acid. They are often prescribed for long-term use.

Other Medications

If medications to reduce or block stomach acid don’t work, you may be switched to another type of medication. Some work to strengthen the LES and UES. Some help the stomach empty better.

If you feel a painful burning sensation in your chest after you eat, you may have gastroesophageal reflux disease (GERD). Heartburn is a classic symptom of GERD, but you may have other symptoms as well.

When You Have a Reflux Problem

With GERD, the weak LES allows food and fluids to travel back, or reflux, into the esophagus.

After you eat, food travels from your mouth down the esophagus to your stomach. Along the way, food passes through a one-way valve called the lower esophageal sphincter (LES), the opening to your stomach. Normally the LES opens when you swallow. It allows food to enter the stomach, then closes quickly. With GERD, the LES doesn’t work normally. It allows food and stomach acid to travel back (reflux) into the esophagus.

Some Common Symptoms

• Frequent heartburn or burping
• Sour-tasting fluid backing up into your mouth
• Symptoms that get worse after you eat, bend over, or lie down
• Difficulty or pain when swallowing

Relieving Your Discomfort

You and your health care provider can work together to find the treatment options that best relieve your symptoms. These may include lifestyle changes, medication, and possibly surgery.