Acid Reflux Surgery Can Provide Much Needed Relief
Millions of individuals suffer from acid reflux every day in the United States and throughout the world. Fortunately, most of these individuals are able to successfully manage their symptoms and control their acid reflux through use of over-the-counter or prescription medications, natural therapies, or changes in lifestyle.
But for those who are unable to find relief using those methods, surgical procedures can be performed to treat the weakened area between the stomach and the lower esophagus. These surgeries may also help strengthen the lower esophageal valve which, if weakened or injured, can allow stomach acid to escape from the stomach, causing chronic acid reflux.
Two primary types of surgery are currently used to surgically treat acid reflux: fundoplication and endoscopy, which actually comprises several different procedures.
Fundoplication is a surgical procedure which tightens the area of the upper stomach, or fundus, around the lower esophagus. During the procedure, the surgeon gathers the fundus around the lower portion of the esophagus and sutures it in place. The esophagus passes into the stomach through a much smaller opening, helping to keep stomach acid from escaping upward and into the esophagus. The procedure may also strengthen the lower esophageal sphincter over time.
Fundoplication may also be used in patients whose acid reflux is a result of specific medical conditions, such as erosive esophagitis or in the presence of a hiatal hernia. The procedure is usually also indicated when chronic acid reflux results in aspiration of stomach fluid, damaging the airway and lungs.
Fundoplication is most often performed laparascopically. In this type of surgery, a small incision is made in the stomach or chest, just large enough to allow a small, lighted tube, or laparoscope, into the injured area. Surgery is performed through this tiny incision. Recovery time is minimal, usually requiring only a brief hospital stay of two to three days.
In some individuals, an open procedure is required. In this procedure, a larger incision is made, allowing the surgeon to access the area with traditional tools and techniques. Recovery can take several days to a week for this type of surgery.
Following your procedure, your doctor will prescribe dietary restrictions to speed healing and prevent a recurrence of acid reflux. These restrictions usually limit consumption of fried and fatty foods, as well as caffeine and alcohol. Most surgeons also advise eating smaller, more frequent meals.
One of the most common endoscopic procedures used to treat acid reflux is a radiofrequency treatment. This procedure can be performed on an outpatient basis, and uses radiofrequency to heat the lower esophageal sphincter to create controlled scarring in the esophagus and the upper stomach area. By scarring these areas in a highly precise and controlled manner, the tissue surrounding the sphincter can be thickened, which can also help strengthen the sphincter, reducing acid reflux. This procedure takes about an hour to perform and recovery is minimal, with many patients resuming their normal routines within a day of the procedure. Radiofrequency procedures are most often performed in patients who are able to control their symptoms with medication, but who do not wish to depend on continual use of medication. In some cases, medication will still be required on an occasional basis following radiofrequency treatment.
Endoscopic suturing is another non-invasive procedure which requires neither general anesthesia nor an incision. In this procedure, a tiny device attached to the endoscope is used to suture, or sew, specific areas near the lower esophageal sphincter. By tying off these areas, the valve is tightened, which can help prevent the occurrence of acid reflux.
Endoscopic procedures may also be used to dilate the esophagus, or areas of the esophagus which have become narrowed. Often, this procedure may be required in patients who have difficulty swallowing following a fundoplication procedure. Many patients require several treatments to achieve satisfactory dilation. In some cases, proton pump inhibitors may be used to reduce the number of treatments required.
Your physician will be able to determine which surgical procedure is best for you, based on your specific symptoms and your history of previous acid reflux treatments.