1. Heard of G.E.R.D.?
GERD is the abbreviated term used for gastroesophageal reflux disease. GERD occurs when the muscular sphincter at the lower end of the esophagus allows food to escape from the stomach and flow back up the esophagus. GERD is a more serious form of acid reflux, although most people interchange the terms. The muscular sphincter, the lower esophageal sphincter (LES) may either fail to close properly or it may open at the wrong time. When the LES sphincter muscle fails to open or close properly, food that is already in the stomach (mixing with digestive acids) can leak and flow back up the esophagus. Symptoms of GERD include pain or burning of the throat or esophagus, an acid taste at the back of the throat and a burning pain near the breastbone or the middle of the abdomen. If left untreated, GERD can lead to inflammation of the esophagus, esophageal strictures, bleeding or ulcers. Untreated GERD can also lead to Barrett's Esophagus, a condition where the cells that line the esophagus change shape and color, becoming high risk for developing cancer of the esophagus.
2. Enter the Endoscope
Endoscopic surgery for GERD patients is considered minimally invasive, because no incisions have to be made to access the esophagus and stomach. An endoscope is a flexible tube with a light attached at the end of it so the area can be visualized by the doctor. Endoscopic surgeries are done on an outpatient basis and no overnight stay is involved. There are three types of endoscopic surgery used to treat GERD in the least invasive way possible. In the EndoCinch and Plicator endoscopic surgery, the doctor places stitches in the LES. The stitches create a pleated appearance in the LES, which helps to strengthen the LES muscle. The Stretta type of endoscopic surgery uses electrodes to burn the LES. As the LES heals, the burns create scar tissue, which helps toughen the LES.
3. Fix it With Fundoplication
The Nissen fundoplication is a more involved surgery than endoscopic, but is still considered minimally invasive. The Nissen procedure is done by way of a laparoscopy, which is also known as "band aid surgery." In the Nissen procedure, two small incisions are made in the abdomen so instruments can be inserted. The upper part of the stomach is then wrapped around the LES to strengthen it and any hiatal hernia can also be repaired at the same time. Although laparoscopy is more invasive than endoscopy, it may be necessary to treat certain cases of GERD. Most people can leave the hospital within a day or two of the Nissen fundoplication.
