Gastroesophageal reflux disease (GERD) is the condition in which there is reflux of gastric contents into the esophagus due to failure of the lower esophageal sphincter, which is a normal mechanism that prevents stomach fluids and food from refluxing into the esophagus after eating.
Gastroesophageal reflux is mainly due to modern lifestyle and eating habits (alcohol, coffee, spicy foods, smoking, etc.). Also, the existence of a hiatal hernia (fig), pregnancy, obesity, and daily habits favor reflux.
Gastroesophageal reflux – Symptoms
It manifests clinically with burning pain behind the sternum, acid belching, epigastric heaviness, and indigestion. Symptoms worsen with lying down and often occur after a large meal.
Complications
- esophagitis, caused by chronic chemical irritation of the esophagus from reflux of gastric acid
- complications of esophagitis such as ulcers, bleeding, and benign esophageal strictures.
The most serious complication is the progression of esophagitis to Barrett’s esophagus, which is a severe dysplasia of the mucous membrane that can lead to cancer.
Gastroesophageal reflux disease – Diagnosis
The diagnosis is confirmed by:
- gastroscopy
- biopsies of the esophagus
Treatment
Treatment is initially conservative with a change in eating habits and medication aimed at reducing gastric secretion and acidity. The duration of the treatment ranges from a few weeks to months, depending on the severity of the esophagitis. When conservative treatment does not work, surgical treatment is deemed necessary, especially when there is a hiatal hernia.
Indications for surgical treatment
- Failure of conservative treatment.
- Recurrence of GERD after reduction of medication.
- Severe esophagitis.
- Complications of esophagitis such as ulceration, stricture, Barrett’s esophagus, or respiratory complications.
- Large sliding hiatal hernia.
The most classic surgery is the NISSEN Fundoplication, which corrects the hiatal hernia and then creates a valve mechanism between the stomach and esophagus, wrapping the upper part of the stomach around the esophagus.
The operation is performed laparoscopically and takes about an hour. The patient walks in 3-4 hours and leaves the hospital the next day without postoperative pain. Most of the time he is back to work in 3-4 days without needing medication or dieting.
General Surgeon Nikos Vlachos, who specialized in Laparoscopic Surgery and is a member of the Hellenic Society of Endoscopic Surgery, is at your disposal to provide you with a personalized diagnosis and recommend the appropriate treatment.
Contact the doctor for any questions or clarification regarding this.
