Gastroesophageal reflux disease

Gastroesophageal reflux disease (GERD) is a chronic digestive condition which occurs when digestive acid or, sometimes, digestive contents, moves back into the oesophagus. The backward motion irritates the lining of the oesophagus, which causes GERD. This is sometimes referred to as ‘severe heartburn’.

Causes and Contributing Factors to Gastroesophageal Reflux Disease

Gastroesophageal reflux disease occurs when the lower oesophageal sphincter does not work properly in closing after swallowing, which can cause a backward motion of the food.

GERD could occur from a birth defect of having a weak lower oesophageal sphincter. Other factors include:

  • fatty and spicy foods
  • certain types of medication like antibiotics, such as tetracycline or pain relievers, such as ibuprofen (Advil, Motrin IB, others) and aspirin can irritate the lining of your oesophagus, causing it to weaken
  • tight clothing
  • smoking
  • drinking alcohol or excess intake of caffeine
  • vigorous exercise

Symptoms of Gastroesophageal Reflux Disease

Heartburn (burning sensation in the chest) is the most common symptom of gastroesophageal reflux disease. Other symptoms include:

  • Chest pain.
  • Difficulty swallowing
  • Dry cough.
  • Hoarseness or sore throat.
  • Regurgitation of food or sour liquid (acid reflux)
  • Sensation of a lump in your throat

Treatment of Gastroesophageal Reflux Disease (laparoscopic fundoplication)

Usually doctors will prescribe some medication and recommend lifestyle and dietary changes to help combat GERD. The International Foundation of Gastrointestinal Disorders provides detailed information on such lifestyle and nutritional choices. (http://www.mayoclinic.org/diseases-conditions/gerd/expert-answers/heartburn-gerd/faq-20058535)

In severe cases, the doctor may advise surgery, known as laparoscopic (keyhole surgery) fundoplication. Fundoplication surgery strengthens the valve between the oesophagus and stomach, which stops acid from moving back up the oesophagus easily.

What Happens During Surgery?

During fundoplication surgery, the upper arc of the stomach is infolded around the oesophagus, then stitched into place, so that the lower portion of the oesophagus goes through a small tunnel of stomach muscle. The procedure is usually done through the abdomen, but in cases where a person is overweight or has a short oesophagus, it may be done through the chest. Fundoplication is usually done via keyhole or laparoscopic technique. This requires only small incision, which shortens the recovery time after surgery.

Post Fundoplication Surgery

During the recovery process, you will need to watch your diet closely. Be mindful of the texture, temperature and types of foods you eat, to avoid irritation of the oesophagus. Your diet will progress from liquids to soft solid as you recover and are able to tolerate it, but it may take time before you are fully back on solid foods. Learn more about lifestyle and nutritional choices after surgery here (https://www.med.unc.edu/gisurgery/patientinfo/refluxsurgery/post-op)

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