GERD Disease Treatment

Reflux of acidic gastric contents into the esophagus via the lower esophageal sphincter. Patients usually complain of symptoms of heartburn, a retrosternal burning pain , increased on bending or lying down. Regurgitation of food and acid (waterbrash) into the mouth usually occurs. Night symptoms, breathing difficulties and voice changes can also happen in severe cases of acid reflux.

Symptoms are worse or other risk factors include hiatus hernia, pregnancy, obesity, excessive alcohol ingestion, cigarette smoking, coffee, red wine, anticholinergic drug, esophageal dysmotility and systemic sclerosis.Patients are usually investigated with upper GI endoscopy, 24-hour intraluminal pH monitoring and manometry studies. Expert consultation is usually recommended for evaluation and treatment of these patients.

GERD

When stomach acid runs back into the tube (esophagus) that connects your mouth and stomach, it's called gastroesophageal reflux disease (GERD). This acid reflux might irritate your esophageal lining.

A large number of people experience acid reflux at some point in their lives. GERD is defined as mild acid reflux occurring at least twice a week or moderate to severe acid reflux occurring at least once a week.

The majority of people may control their GERD symptoms with a combination of lifestyle adjustments and over-the-counter drugs. To give the patients relief from GERD harsher drugs or surgery may be required. 

Why GERD Happens?

In general, the esophageal sphincter (valve) closes tightly after the food enters your stomach. But sometimes, due to weakness or relaxation of the lower esophageal sphincter (valve), acid reflux is caused. 

The valve relaxes, allowing acid and food to return to the food pipe. Factors that may cause GERD.

• An excessive amount of pressure is applied to the abdomen. Because of the additional pressure, some pregnant women feel heartburn almost every day.

• Food choices (dairy, spicy, or fried dishes, for example) and eating practices.

• Medications used to treat asthma, high blood pressure, and allergies, as well as painkillers, sedatives, and antidepressants excessiveness can lead to GERD.  

• Due to hiatal or stomach hernia. 

GERD Classification

GERD is classified into three different phenotypes:

• Non-erosive reflux disease (NERD)

• Erosive esophagitis (EE)

• Barrett esophagus (BE)

GERD is further classified on the basis of its severity, types, and symptoms. 

• Mild GERD: Minimal acid reflux occurs once or twice a month and can be managed by a healthy lifestyle and dietary changes. Over the counter medications can be prescribed. This stage comes under non-erosive reflux disease (NERD).

• Moderate GERD: Frequent symptoms, where acid flux medication prescription is required. This is usually a condition that is the advanced version of NERD, as in this ulcers can occur. 

• Severe GERD: At this stage, in some cases, the medication does not work and surgery may be needed. This condition is part of erosive esophagitis (EE).

• Precancer or Cancer: This stage occurs when GERD is untreated for several years. Which results in the development of a precancerous stage known as Barrett's esophagus.

GERD Symptoms 

Irritation and discomfort in the throat are the first lines of symptoms; others are mentioned below. Consulting your doctor is a must if you face any of these symptoms.

• Heartburn (usually after eating, which might be worse at night)

• Chest pain.

• Difficulty swallowing food and water.

• Backflow of food or sour liquid.

• A sensation of a lump in your throat.

• Vomiting

• Sore throat and hoarseness.

• Dental problems

GERD Diagnosis

The symptoms of GERD are typically used to make a diagnosis. If it doesn't go away despite lifestyle changes and medications, the doctor may prescribe one or more of the following diagnostic tests:

• Esophageal pH monitoring

• Endoscopy

• Manometry

• Radiography

• An X-ray of your upper digestive system

GERD Complications

If GERD is left untreated, it can cause serious issues and can develop chronic inflammation. The treatment is crucial because there are many complications that are associated with it. 

• It can damage the lower esophagus due to stomach acid and can cause ulcers.

• Narrow food pathways lead to painful swallowing of food.

• An esophageal ulcer can bleed and cause pain.

• All those things can increase the risk of esophageal cancer.

Surgery

There are two types of surgeries that are offered for patients suffering from incisional hernia. Open hernia repair with mesh and the other most common type of surgery is Laparoscopic hernia repair with mesh. Broadly these surgeries based on the technique can be classified as OPEN SURGERY and MINIMALLY INVASIVE SURGERY.

OPEN SURGERY- Open Nissen fundoplication repair with or without mesh

Open surgery involves open technique. Here an incision is made on the abdomen. The area of the stomach and esophagus is identified. If there is a hernia the hernia is reduced. The esophagus is mobilized to obtain adequate intra abdominal length. The lower esophageal opening in the diaphragm is evaluated and the cura is approximated over a bougie.  The stomach is then wrapped around the mobilized esophagus to recreate the valve to prevent reflux. The surrounding structures are evaluated and the incision is closed.

Open surgery is usually more painful than the minimally invasive surgeries. But there are various medications that we use to help you have better pain control.

For this surgery you may need a complete blood count (CBC), chemistry profile, PT, PTT. Depending on your medical history, we may require additional testing: chest X-Ray, EKG, medical clearance from your primary care physician, cardiac clearance from your cardiologist, additional blood work and finally Anesthesiology clearance.

We recommend that you have your blood work done before having the surgery performed. If this is not possible, please notify the surgical scheduling team at 8884200030.

MINIMALLY INVASIVE SURGERY- Laparoscopic Nissen fundoplication with or without mesh

Laparoscopic surgery involves minimally invasive technique. Here we make small 5 mm incisions on the upper right and left side of the abdomen and small 10 mm incisions are also made. The abdomen is entered and the area of the stomach and esophagus is identified. If there is a hernia the hernia is reduced. The esophagus is mobilized to obtain adequate intra abdominal length. The lower esophageal opening in the diaphragm is evaluated and the cura is approximated over a bougie. The stomach is then wrapped around the mobilized esophagus to recreate the valve to prevent reflux. The surrounding structures are evaluated and the incision is closed.

Laparoscopic surgeries are usually less painful than the open surgeries. We still give you pain medications and nerve blocks so that you feel comfortable and are able to walk about six hours after the surgery.
For this surgery you may need a complete blood count (CBC), chemistry profile, PT, PTT. Depending on your medical history, your physician may require additional testing: chest X-Ray, EKG, medical clearance from your primary care physician, cardiac clearance from your cardiologist, additional blood work and finally Anesthesiology clearance.
We recommend that you have your blood work done before having the surgery performed. If this is not possible, please notify the surgical scheduling team at 8884200030

Patient education

BEFORE SURGERY

Please refer to the instructions below in preparation for your surgery. Proper preparation is essential to obtain the best surgical experience and results. Please note that failure to follow these instructions may result in rescheduling your surgery. Our team will contact each patient directly and will be available to answer any additional questions about surgery, scheduling and instructions.

PRE-OPERATIVE TESTING

You may need a complete blood count (CBC), chemistry profile, PT, PTT. Depending on your medical history, your physician may require additional testing: chest X-Ray, EKG, medical clearance from your primary care physician, cardiac clearance from your cardiologist, blood work and anesthesiology clearance.
We recommend that you have your blood work done at the hospital where you are having the surgery performed.

Please download instructions below if you need any further instructions, please notify the surgical scheduling team at 8884200030

why us?

GERD is a serious disorder and needs proper treatment to minimize the risk. The treatment involves medication like Proton pump inhibitors (PPIs) and surgeries (Laparoscopic surgery or Bariatric surgery) may be offered if the symptoms continue and worsen. The treatment varies as it depends on the stage and symptoms that can only be known after diagnosis. 

MH Surgery Clinic is the best gastroenterology hospital in Bangalore equipped with the team of finest gastro surgeons in Bangalore and determined to provide world-class treatment. Our surgical gastroenterologists are experienced in dealing with laparoscopic surgeries to cure GERD.

 If you experience any symptoms consult our gastroenterologist in Bangalore.

Our minimally invasive Surgeons are well known internationally in their field. They are experts in the diagnosis and management of various conditions, and innovation of minimally invasive surgery techniques. Our team provides a personalized approach for each patient, offering advanced surgical solutions. Our gastroenterologist doctor in Bangalore educates physicians on innovative techniques through national, international presentations and web-based seminars.