Medical and Surgical Treatment Options
GERD is generally treated in three progressive steps:
1. LIFE STYLE CHANGES
In many cases, changing diet and taking over-the-counter antacids can reduce how often and how harsh your symptoms are. Losing weight, reducing or eliminating smoking and alcohol consumption, and altering eating and sleeping patterns can also help.
2. DRUG THERAPY
If symptoms persist after these life style changes, drug therapy may be required. Antacids neutralize stomach acids and over-the-counter medications reduce the amount of stomach acid produced. Both may be effective in relieving symptoms. Prescription drugs may be more effective in healing irritation of the esophagus and relieving symptoms. This therapy needs to be discussed with your primary care provider and your surgeon.
Patients who do not respond well to lifestyle changes or medications or those who do not wish to continually require medications to control their symptoms, may consider undergoing a surgical procedure. Surgery is very effective in treating GERD. The most commonly performed operation for GERD is called a fundoplication (usually a Nissen fundoplication, named for the surgeon who first described this procedure in the late 1950’s). A fundoplication involves fixing your hiatal hernia, if present, and wrapping the top part of the stomach around the end of the esophagus to reinforce the lower esophageal sphincter, and this recreate the “one-way valve” that is meant to prevent acid reflux. This can be done using a single long incision on the upper abdomen, or more commonly by minimally invasive techniques using several small incisions, called laparoscopic surgery.
What are the Advantages of the Laparoscopic Method?
The advantage of the laparoscopic approach is that it usually provides:
- reduced postoperative pain
- shorter hospital stay
- a faster return to work
- improved cosmetic result
Are You a Candidate for the Laparoscopic Method?
Although laparoscopic anti-reflux surgery has many benefits, it may not be appropriate for some patients. Obtain a thorough medical evaluation by a surgeon qualified in laparoscopic anti-reflux surgery in consultation with your primary care physician or Gastroenterologist to find out if the technique is appropriate for you.
How the Surgery is Performed
What to Expect Before Laparoscopic Anti-Reflux Surgery?
- After your surgeon reviews with you the potential risks and benefits of the operation, you will need to provide written consent for surgery.
- Preoperative preparation includes blood work, medical evaluation, chest x-ray and an EKG depending on your age and medical condition.
- Additional test may be needed prior to surgery, which will be ordered by your surgeon based on your individual history
- It is recommended that you shower the night before or morning of the operation.
- After midnight the night before the operation, you should not eat or drink anything except medications that your surgeon has told you are permissible to take with a sip of water the morning of surgery.
- Drugs such as aspirin, blood thinners, anti-inflammatory medications (arthritis medications) and Vitamin E will need to be stopped temporarily for several days to a week prior to surgery.
- Diet medication or St. John’s Wort should not be used for the two weeks prior to surgery.
- Quit smoking and arrange for any help you may need at home.
What to Expect the Day of Surgery:
- You usually arrive at the hospital the morning of the operation.
- A qualified medical staff member will place a small needle/catheter in your vein to deliver medication during surgery.
- Often pre-operative medications are necessary.
- You will be under general anesthesia – asleep – during the operation which may last several hours.
- Following the operation you will be sent to the recovery room until you are fully awake.
- Most patients stay in the hospital the night of surgery and may require additional days in the hospital.
Brought to you by:SOCIETY OF AMERICAN GASTROINTESTINAL AND ENDOSCOPIC SURGEONS (SAGES)
11300 West Olympic Blvd., Suite 600
Los Angeles, CA 90064
- (310) 437-0544
- (310) 437-0585
- March 1, 2015