With GERD, the weak LES allows food and fluids to travel back, or reflux, into the esophagus.
Hiatal Hernia and Anti-Reflux Procedures
What Is GERD?
Surgery for GERD
Lifestyle Changes for Controlling GERD
Medications for Acid Reflux
Laparoscopic and Minimally Invasive Treatment for Heartburn (GERD)
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What Is GERD?
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.
Note: Chest pain may also be caused by heart problems. Be sure to have all chest pain evaluated by a doctor.
When You Have a Reflux Problem
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 doctor can work together to find the treatment options that best relieve your symptoms. These may include lifestyle changes, medication, and possibly surgery.
Surgery for GERD
Lifting the Esophagus
Stomach being wrapped around the esophagus. This added support helps prevent reflux.
The wrap is permanently stitched in place. Two commonly used wraps are full and partial.
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.
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.
Risks and Complications
- Injury to the liver, spleen, esophagus, or stomach
- Infection
- Increased gas or bloating
- Bleeding
- An inability to vomit
- Difficulty swallowing
- Failure of the operation to eliminate GERD
Lifestyle Changes for Controlling GERD
When you have GERD, stomach acid feels as if it’s backing up toward your mouth. Whether or not you take medication to control your GERD, your symptoms can often be improved with lifestyle changes. Talk to your doctor about the following suggestions, which may help you get relief from your symptoms.
Raise Your Head
Reflux is more likely to strike when you’re lying down flat, because stomach fluid can flow backward more easily. Raising the head of your bed 4-6 inches can help. To do this:
- Slide blocks or books under the legs at the head of your bed. Or, place a wedge under the mattress. Many foam stores can make a suitable wedge for you. The wedge should run from your waist to the top of your head.
- Don’t just prop your head on several pillows. This increases pressure on your stomach. It can make GERD worse.
Watch Your Eating Habits
Certain foods may increase the acid in your stomach or relax the lower esophageal sphincter, making GERD more likely. It’s best to avoid the following:
- Coffee, tea, and carbonated drinks (with and without caffeine)
- Fatty, fried, or spicy food
- Mint, chocolate, onions, and tomatoes
- Any other foods that seem to irritate your stomach or cause you pain
Relieve the Pressure
- Eat smaller meals, even if you have to eat more often.
- Don’t lie down right after you eat. Wait a few hours for your stomach to empty.
- Avoid tight belts and tight-fitting clothes.
- Lose excess weight.
Tobacco and Alcohol
Avoid smoking tobacco and drinking alcohol. They can make GERD symptoms worse.
Medications for Acid Reflux
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.