GERD is often due to malfunction of the valve between the esophagus and stomach which allows stomach acid to flow back into the esophagus. Sometimes GERD can be caused by anatomical issues such as a hiatal hernia, or when the upper part of the stomach bulges into the diaphragm, preventing normal food intake.
What are the symptoms of GERD?
The most common symptoms of GERD are heartburn, regurgitation, difficulty swallowing and coughing. More serious complications from long-term acid reflux can occur, including:
- Recurring pneumonia
- Barrett’s esophagus
- Esophageal cancer
What treatment options are available?
The first step to managing GERD symptoms is lifestyle changes and over-the-counter medications. Some of these medications may have adverse side effects with short- or long-term use. If these don’t control symptoms, or if you do not wish to take medications for an extended period, surgery may be recommended.
“Young, healthy individuals who do not wish to take medication the rest of their life may benefit from surgery earlier,” says Dr. Jose Lopez, board certified general surgeon at Austin Surgeons. He also recommends surgery if GERD is caused by a large hiatal hernia or paraoesophageal hernia. “These conditions can cause painful swallowing, shortness of breath, or even recurrent lung infections.”
Laparoscopic Fundoplication and Hiatal Hernia Repair
Surgery for GERD is known as a laparoscopic fundoplication. During surgery, the valve between the esophagus and the stomach (the lower esophageal sphincter or LES) is reinforced and if a hernia is present, it is repaired. Laparoscopic fundoplication may be performed by standard laparoscopy or by robotic-assisted laparoscopy.
Dr. Lopez says recent long-term studies show that the success rate of GERD surgery is approximately 90% and complications are rare.
After surgery, a progressive liquid diet is required for 1-2 weeks before returning to a normal diet. It is common to experience some slowness of swallowing due to swelling around the lower esophagus and the fundoplication. This will gradually resolve but may persist for several weeks. Burping can be more difficult after surgery, which may cause more flatulence.