Gastroesophageal Reflux Disease (GERD) Treatment
GERD/Heartburn Symptoms
Heartburn, also known as acid indigestion, is the most common symptom of GERD and usually feels like a burning chest pain which begins behind the breastbone and moves upwards to the neck and throat. Some people experience acidic or bitter taste.
Symptoms include:
- Chest pain
- Difficulty in swallowing (dysphagia)
- Dry cough
- Hoarseness or sore throat
- Regurgitation of food or sour liquid (acid reflux)
- Sensation of a lump in your throat
Treatment Options
Anti-reflux surgery may be appropriate for:
- Patients who do not want to take proton pump inhibitor (PPI) medications for life
- People who develop complications from PPIs
- Patients who are allergic to PPI medications
- Patients who develop resistance to PPI medications
- Patients who develop complications from GERD despite taking PPI medications. (i.e., bleeding, ulcers, strictures)
- Patients who have proximal reflux complications. (i.e., asthma, hoarseness, pneumonia)
Options for Treatment:
Magnetic Sphincter
A small magnetic sphincter device is implanted by the surgeon around the outside of the lower esophageal sphincter to tighten the opening and prevent stomach acid from entering the esophagus. The device is a small implant comprised of interlinked titanium beads with magnetic cores that is placed during a minimally invasive laparoscopic procedure. Following the procedure, patients with the device may eat normally.
Nissen 360 Degree Fundoplication
In this procedure, the surgeon wraps the upper part of the stomach (the gastric fundus) around the lower end of the esophagus and stitches it into place. This reinforces the closing function of the lower esophageal sphincter and helps prevent the reflux of gastric acid into the esophagus.
Toupet 270 Degree Partial Fundoplication
Toupet 270 degree fundoplication in which the upper part of the stomach is secured to the back of the lower esophagus at the 10:00 and 2:00 positions creating a partial wrap.
Revision Anti-Reflux Surgery
A small sub-group of patients who undergo anti-reflux surgery for GERD may initially do well and then experience recurrent symptoms or complications because of a hiatal hernia or issues related to their wrap or magnetic sphincter device. These patients are candidates for a laparoscopic revision procedure to address their issues.