Surgical Options Offer Hope For GERD Patients

Written by Thomas Green

While gastrointestinal reflux disease can be treated by a number of lifestyle and dietary changes, and also a plethora of medications. Sometimes these treatments aren't enough to treat the painful heartburn, difficulties in swallowing, vomiting and other unpleasant symptoms of GERD, and more aggressive options must be considered.

GERD is caused by weaknesses or malfunctions in the valve that partitions the esophagus from the stomach. These malfunctions or weaknesses can allow stomach acids or partially digested food reflux into the esophagus, irritating its lining and causing severe discomfort. This can eventually result in more serious illnesses, including cancer. Treating GERD is therefore imperative to improving the quality of life of GERD sufferers, and perhaps even saving their lives.

GERD occurs in many Americans, particularly the elderly, but 90 percent of these cases are controllable through medication. Most GERD medications work to reduce the amount of stomach acid produced, thus mitigating the effect of acid reflux. These medications may not always work, or may not always work to the degree necessary. Because the root cause of GERD is basically a malfunction of the mechanics of the body, i.e. a weakening of the lower esophageal sphincter, there are some surgeries that can be considered to correct the problem.

For those patients, and for patients who want a permanent fix to the problem, surgery presents some good options. According to MSN, more than 40,000 Americans undergo surgical treatment for GERD each year. These techniques are expected to become more widespread as GERD is becoming more common because of the increasing obesity of the American people, improved diagnostics are identifying more people who can benefit from the surgery, the techniques involved in the surgery are becoming more refined, increasing the success rate, and thanks to laproscopic techniques the surgery is becoming less invasive, causing less pain and decreasing recovery time.

Patients who wish to be treated surgically for GERD will need a referral from a physican. Medicare, Medicaid and most insurers cover procedures to manage GERD.

Gastroplication is a surgical technique that can strengthen the lower esophageal sphincter by stitching a pleat near it to strengthen it. The surgery is done by a very tiny sewing device and laproscopic cameras that are inserted into the chest via small incisions. This procedure has been deemed successful by early studies which show the vast majority of patients see a marked reduction in their incidences of acid reflux, and a reduction in the severity of their symptoms if it does happen. In fact, nearly 70 percent of patients who undergo this procedure can forgo medication after this procedure.

An esophageal implant is another surgical option that can resolve GERD. This procedure involves injecting a polymeric material into the muscles of the lower esophageal sphincter. This material forms a permanent implant in the lower esophageal sphincter that bolster's its effectiveness, helping it to better prevent acid reflux. One of the benefits of this option is that it does not involve cutting into the body, and thus can be performed in an outpatient setting. Recovery time is short, as most patients return home that day and can generally resume normal activity in one to two days following the procedure. Side effects are mild and may include a sore throat and some nausea for the first couple of days after the operation. Pain can be easily managed with over the counter pain reliever products, such as Tylenol or Motrin.

Perhaps the most widespread surgery for GERD is laproscopic fundoplication, also known as Nissen Fundoplication. This surgery works by strengthening the esophageal valve by wrapping the upper end of the patient's stomach around the lower end of the esophagus. The wrap is sewn into place, further strengthening the lower esophageal valve. The strengthened valve helps by reducing incidences of acid reflux. It takes about an hour and a half to complete a fundoplication, and while the surgery once required doctors to open the chest to perform the proctedure, laproscopic techniques now allow the procedure to be accomplished with just a few small incisions. The surgery is generally done in a hospital setting, and patients generally are up to going home in a day or two after the procedure. Patients generally return to normal activity within two weeks after the surgery and can resume a normal diet after about a month. Fundoplication has a good success rate, with only about 10 or 15 percent of patients requiring further treatment or surgery.

When deciding which surgical option you wish to take, you should consult with your doctor and give him or her as much information about your medical history as possible. This will allow your doctor to pick the treatment that's safest and most likely to be effective for your particular circumstances.