Surgery for Gastric Reflux

Gastric reflux, or heartburn, is a condition that affects many people although mostly in the form of an occasional heartburn episode—controllable with an antacid—which is the extent of the suffering.
Others, however, may suffer from G.E.R.D. (Gastro-Esophageal Reflux Disorder) on a more frequent basis, sometimes even daily. Heartburn attacks experienced on a daily basis can provoke more serious conditions such as ulcers and an eventual narrowing of the esophagus.

Most of the time, people who suffer from heartburns can make lifestyle changes that will dramatically improve their condition. For instance, making sure not to lie down after eating, avoiding tight clothing, quitting smoking, losing weight and eliminating fatty and acidic foods from the diet will usually solve the problem of heartburn altogether. By taking specially prescribed medications in combination with these precautions, heartburn can become a rare, or nonexistent occurrence.

Yet for some people, despite medication and lifestyle changes, heartburn persists in the form of chronic acid reflux. In severe cases, the lower esophageal sphincter (LES) may actually be weakened; allowing the acids from the stomach to flow upwards into the lower esophagus. If the condition is due to a weakened LES, no amount of medication or lifestyle change will help the problem. In these extreme conditions, surgery might be the final option.

Surgery will usually focus upon strengthening the LES in order to permanently prevent the upward flow of acids into the esophagus. Due to the advances in modern technology, namely the use of video (or a laparoscope), large incisions are no longer necessary. This significantly alters the amount of scarring and pain that often accompanied the operation.

In the past, it was common for patients to spend up to six weeks recovering from this operation. Nowadays, with the use of the technique known as "Laparoscopic Nissen Fundoplication", very small incisions are necessary and the recovery time is much faster. Often patients will spend only a day or two in the hospital and can recover their normal working activity within a week.

What exactly does this surgery do? The main goal of gastric reflux surgery is to strengthen the LES and prevent acid flow from the stomach. There are three different stages that make up this operation. First, due to the possibility of hiatal hernia- a condition where the stomach works its way upwards into the diaphragm- the stomach is repositioned in its normal location. Secondly, this opening in the diaphragm is closed in order to prevent a future occurrence of hiatal hernia. And finally, a “Fundal wrap” is applied to the LES. In other words, part of the stomach is wrapped around the lower esophagus in order to strengthen the permanently strengthen the muscle.

Gastric reflux surgery is not always recommended for extreme conditions. People who have a major illness, heart disease or have had previous operations to the stomach area in the past might not be fit for anti reflux surgery. Before undergoing the operation, all other possibilities should be ruled out. The patient must be properly diagnosed by a physician and considered fit for the operation.

After surgery, some patients will find it difficult to swallow solid foods. This is very common and, fortunately, only temporary. Because the lower esophageal sphincter has been strengthened, difficulty vomiting or belching is also common. This problem usually subsides after around two weeks. Although these side effects immediately after the surgery are common, about 90 percent of gastric reflux surgery patients recover without further complications.