As with any other problem, the treatments and drugs available for GERD are numerous. Some of the simple treatments would be a change in lifestyle and anti-acidic medicines. Another alternative treatment for the condition of GERD would be surgery. Surgery is usually not prescribed at the onset of the condition. It is an option chosen when all the other treatments and medicines are found to be ineffective. Sometimes all the treatments given could prove to be of no use and this necessitates the surgery. However, it should be kept in mind that surgery is the last option under consideration.
1. Surgical therapy is a treatment option for long-term therapy in GERD patients. (Strong recommendation, high level of evidence)
2. Surgical therapy is generally not recommended in patients who do not respond to PPI therapy. (Strong recommendation, high level of evidence)
3. Preoperative ambulatory pH monitoring is mandatory in patients without evidence of erosive esophagitis. All patients should undergo preoperative manometry to rule out achalasia or scleroderma-like esophagus. (Strong recommendation, moderate level of evidence)
4. Surgical therapy is as effective as medical therapy for carefully selected patients with chronic GERD when performed by an experienced surgeon. (Strong recommendation, high level of evidence)
5. Obese patients contemplating surgical therapy for GERD should be considered for bariatric surgery. The gastric bypass would be the preferred operation in these patients. (Conditional recommendation, moderate level of evidence) The usage of current endoscopic therapy or transoral incisionless fundoplication cannot be recommended as an alternative to medical or traditional surgical therapy. (Conditional recommendation, moderate level of evidence).
Acid reflux is treated by a surgery known as a fundoplication procedure. In this surgery, very small incisions are made in the upper abdomen. A camera and surgical instruments are passed through the incision. In the fundoplication procedure, any visible hernia or hernial sac is detached. It is then stitched back into place to reduce the pressure on the diaphragm which is usually the cause of symptoms of acid reflux. Then the muscle where the diaphragm meets the oesophagus is tightened. This reduces the leakage of acid reflux and hence prevents its flow into the oesophagus. An artificial lower oesophageal sphincter is also created in the stomach to reduce future reflux.
The surgical procedure has been found to be more effective than any other treatment method available. It can provide relief from symptoms and complications that occur due to acid reflux. As many as 85% of the patients who undergo the surgery are found to have positive results. The surgery can keep you away from the problems for up to 10 years.
Many patients will still need to follow medication to get relief from the discomfort and pain either because it has not been properly dealt with during the surgery or because the condition has returned. This is the case with almost half of the people who go for surgery. Most of the patients face further complications post the surgery.
The risk associated with surgery is that the food may be trapped by the artificial muscle. This condition can be easily treated. In rare cases, another surgery may be required to open the artificial sphincter to allow the passage of food and correct the problem.
Just like any other surgery, the surgery for acid reflux i.e. fundoplication procedure has potential risks and side effects. Prior to undergoing the surgery, it is necessary to discuss with your surgeon the possible complications and risks associated. You can also find out if any alternative treatment would be better for your condition. Only when all other options are closed, should you opt for surgery. Have a complete talk with the surgeon as to what are the precautions you may have to follow before and post the surgery. All these things will help you to make an informed decision.
The oesophagus can become narrow too due to the extra acid. This means you won’t be able to use it properly. Surgery may be necessary in order to allow the oesophagus to expand as it should. Sometimes acid reflux can be a symptom of a medical concern such as a hernia. Surgery then has to be done to take care of the hernia. Upon doing so the acid reflux will likely disappear on its own.
Some individuals have problems with their lungs. They are more susceptible to pneumonia than others. They can end up with liquids filling up the lungs which make it hard to breathe normally. Surgery can help to prevent such fluids from getting into the lungs and into the oesophagus to cause acid reflux.
A doctor may decide that surgery for acid reflux is necessary so that this condition doesn’t interfere with other types of medications you have to take. You certainly don’t want your overall health to suffer because of your acid reflux problem. You may be getting results from various prescription medications for it but not without a cost. That is that they are expensive for you to purchase on a regular basis. There is also the fact that they can create some side effects that are very disruptive to your daily life.
Surgery can be a very effective way to end your problems with acid reflux. Since there are risks involved with it, this will be the last resort. You will need to discuss the benefits as well as the risks with your doctor. Most of the time such surgery is very effective and a person can get back to enjoying their life.
An assessment of your acid reflux problems will be conducted. Your lifestyle choices including if you smoke or drink will be taken into consideration. Your overall health will also be evaluated as not everyone is healthy enough to undergo such surgery. With the many advances in medical technology today though this can be a success for you. Most people recover from acid reflux surgery within a couple of weeks a well.