Is There Surgery for Acid Reflux?

Is There Surgery for Acid Reflux?

Yes. While many people suffer from acid reflux, not all of them have true acid reflux. It is true that there is a small group of patients who will truly benefit from acid reflux surgery. In this group of patients, surgery can be lifesaving.

What are the symptoms of acidity?

Please read my blog “Is it really acidity? Or is it IBS?”

Which group of patients will benefit from surgery?

Symptoms are caused by acid/food coming into the oesophagus (food pipe) or up to the throat. Surgery should be a treatment of choice in people who suffer from this condition. It is a burning sensation between the ribs or at the back of the throat. In some people, it can lead to recurrent throat infection or change of voice. If symptoms are severe, then it might feel like a heart attack at times.

Some or all of these symptoms are made worse by bending down or when in the lying position.

Why do these symptoms occur?

It happens if there is disruption in the defense mechanisms preventing the food/acid coming up to the chest.

1. Weak Lower Oesophageal Sphincter (LOS): LOS is a one-way valve at the lower end of the oesophagus. It is meant to allow food to go from the oesophagus to the stomach but not the other way around. When it is weak, it leads to acid reflux and burning of the oesophagus (oesophagitis).
2. Hiatus hernia: This is a condition when part of the stomach is in the chest through the weakness of the diaphragm muscle. This might give a sensation of food being stuck in the chest.

Are there other factors that contribute to acid reflux?

Yes. They are:

1. Smoking
2. Alcohol
3. Tight dress
4. Body posture—bending down / lying flat
5. Too much of spicy and fatty/oily food
6. Food habits
7. Certain medications

Is surgery the first choice in all patients?

No

What are the steps before surgery?

Lifestyle changes

Drug therapy

When should one consider surgery?

One should consider surgery in one of the following situations:

1. Medicines are not giving complete cure and some symptoms are persisting in spite of taking medicines.
2. Symptoms are suppressed when one is on medicines but return as soon as one discontinues medicines.
3. One does not wish to take medicines life long and risk serious nutritional deficiencies.

How is surgery performed and what are the benefits?

Now a days, surgery is performed as keyhole (laparoscopic). The surgery may not be complicated and has the following benefits:

1. One is in the hospital only for 2/3 days.
2. One can return to work within a week or so.
3. Scars are barely visible after few weeks.
4. There will be minimal post op pain, which will require simple pain killer medicines.

How is surgery performed?

It recreates the lost anatomical defence mechanism.  In general, the stomach in the chest is returned to the normal abdominal position and the valve that is weak is strengthened. Part of the stomach (fundus) is wrapped around the lower end of the oesophagus to add extra strength to the valve.

Video presentation