Commonly called heartburn or acid indigestion, GERD occurs when the contents of the stomach flow back up into the esophagus. This is generally due to weakness in or damage to the lower esophageal sphincter (LES). The LES should only let food pass from the esophagus into the stomach, not the other way around. When it does, the result is gastroesophageal reflux disease.
Millions of Americans suffer from GERD on a regular basis, and some cases are more extreme than others. There are many possible treatments, ranging from lifestyle modification to surgery. Surgical Associates of WNY offers comprehensive treatment for GERD.
Patients who come into our office will receive a full gastrointestinal (GI) work-up, including:
These tests will provide a complete picture of your GERD and the damage it has caused to your esophagus and stomach lining. Once your surgeon has this insight, he will recommend the appropriate course of treatment.
First steps include adjusting diet and lifestyle. This may mean reducing or eliminating acidic foods, fatty and fried foods, alcohol, chocolate, and other triggers. Timing and spacing meals may also help. Patients often find some relief if they eat dinner at least two to three hours prior to bedtime, for example.
Medications such as antacids, H2 blockers, and proton pump inhibitors are also often used.
If these treatments alone aren’t enough, there are surgical solutions to GERD.
This procedure is effective when the cause of problem is a weak LES. In a fundoplication, the upper portion of the stomach, the fundus, is wrapped around the lower esophagus and sewn into place. This means the esophagus will now pass through a tube of stomach muscle. The goal here is to provide additional muscle strength to this area. By reinforcing the sphincter with this extra muscle, the LES closes more completely and doesn’t allow for the backflow of stomach contents into the esophagus.
When a paraesophageal hernia occurs, it reduces the effectiveness of the LES, causing gastric contents to reflux. Repairing this hernia can bring relief from GERD symptoms.
Transoral incisionless fundoplication (TIF)
Fundoplication is a well-known procedure that can tighten and reinforce the lower esophageal sphincter and prevent stomach acid and stomach contents from entering the esophagus. Transoral incisionless fundoplication (TIF) is a minimally invasive fundoplication approach that is performed through the patent’s mouth and from within the patient’s stomach using no incisions. The incisionless EsophyX device reconstructs the lower esophageal sphincter to restore the body’s natural protection against reflux.
The best candidates for TIF are patients suffering from GERD who regularly experience troublesome symptoms, but who no longer respond to or aren’t satisfied with pharmaceutical therapies. TIF is often performed in conjunction with upper hiatal hernia repair.
Patients with chronic, uncontrollable cough, bleeding disorder, stricture, esophageal abnormalities or obstructions, esophageal stenosis or limited neck mobility may not be good candidates for TIF.
This new technology is providing relief for patients who have been unable to control their symptoms with medication or who are trying to avoid taking medication long-term. The LINX System is a small flexible band of interlinked titanium beads with magnetic cores. When you swallow, the force created by your esophageal muscle is enough to break the magnetic attraction between the beads and let the LINX band expand, thereby allowing food to pass into the stomach. It then contracts and closes the LES. There is no comparable muscle force associated with reflux. Therefore, the band won’t open to allow stomach contents back into the esophagus.
The LINX system looks like a small bracelet that is placed around the lower esophagus just above the stomach. This is done laparoscopically, meaning there is very little scarring, pain, and recovery time.
When you come in for a consultation with your surgeon, you can be sure he will take the time to study your specific symptoms and present you with the course of treatment that is best suited to you.