Gastroesophageal reflux disease (GERD) is a digestive disorder that is caused by gastric acid flowing from the stomach into the esophagus.
Gastroesophageal reflux is the return of acidic stomach juices, or food and fluids, back up into the esophagus. After food passes through the esophagus into the stomach, a muscular valve called the lower esophageal sphincter (LES) closes, preventing the movement of food or acid upward. Gastroesophageal reflux occurs when the LES relaxes inappropriately, allowing acid from the stomach to flow backward into the esophagus.
Heartburn, also called acid indigestion, is the most common symptom of GERD.
If left untreated, gastroesophageal reflux can cause esophageal ulcers, esophageal bleeding, and narrowing of the esophagus.
A hiatal hernia may be associated with GERD.It is caused by an opening in the diaphragm, a flat muscle that separates the chest from the abdomen, allowing a portion of the stomach to protrude into the chest.
Treatment can include lifestyle changes, such as weight reduction, avoiding certain types of food and taking medications to alleviate symptoms.
Surgery_ Anti-reflux operation (Nissen fundoplication) may help patients who have persistent symptoms despite medical treatment. It's also a good option for patients whose symptoms are well controlled but who don't want to take medication, and for patients with complications of reflux disease, such as ulcers, strictures or Barrett's esophagus.
The Nissen Fundoplication is considered the "gold standard" for controlling reflux and repairing hiatal hernia.
the surgery improves the natural barrier between the stomach and the esophagus by wrapping a part of the stomach known as the gastric fundus around the lower esophagus. This prevents the flow of acids from the stomach into the esophagus, and strengthens the valve between the esophagus and stomach, which stops acid from backing up into the esophagus as easily. This procedure is often done using a laparoscopic surgical technique. It can also be done as traditional (open) surgery.
During the laparoscopic Nissen fundoplication procedure, surgeons use small surgical tools and a laparoscope to repair the muscle that separates the stomach and esophagus.
The success rate for the minimally invasive surgery is 90 to 95 percent for patients who have the typical symptoms of GERD, such as heartburn, regurgitation, or belching.