Acid reflux causes the burning sensation in the upper chest and throat known as heartburn. Many people experience heartburn once in a while. If it occurs more than twice a week, it is considered gastroesophageal reflux disease, also called GERD, according to the National Digestive Diseases Information Clearinghouse. Lifestyle changes, over-the-counter remedies or prescription medicine treat GERD in some cases. When these do not relieve or reduce GERD symptoms, surgery to repair a muscle valve in the esophagus is an option.
Function
Acid reflux occurs when a muscle valve in the esophagus does not work properly. The valve, called the lower esophageal sphincter, usually opens to allow food into the stomach and then closes to prevent digestive juices from rising back up into the esophagus. When the valve does not close, stomach acid flows back up into the esophagus and causes heartburn. Sometimes the acids cause a sour taste in the back of the throat or in the mouth.
Considerations
People with GERD are usually advised to avoid certain foods, lose weight, eliminate smoking and alcohol or take medication to reduce stomach acid production. Doctors may recommend surgery when these changes don't work. Patients facing a lifetime of taking medication and going through frequent discomfort may find surgery appealing, according to the National Digestive Diseases Information Clearinghouse.
Techniques
Surgical techniques can strengthen the valve in the esophagus. Nissen fundoplication is a procedure used for many patients. The aim is to wrap the upper portion of the stomach around the lower esophageal sphincter. A technique called laparoscopic anti-reflux surgery, also called laparoscopic Nissen fundoplication, performs the same procedure using a video camera, according to the Society of American Gastrointestinal and Endoscopic Surgeons.
Benefits
In the laparoscopic technique, surgeons make small incisions in the abdomen and insert a laparoscope, a tube-like instrument, connected to a tiny video camera. The doctors can see inside the patient’s abdomen on a television screen and perform the operation to reinforce the valve in the esophagus. Patients can leave the hospital in one to three days. Most patients experience long-lasting relief and reduction of GERD symptoms, the Cleveland Clinic notes.
In some cases, the valve may lose its effectiveness, causing recurrences of symptoms. A second operation can be performed, and many patients have had successful repeated laparoscopic operations.
Alternatives
Some patients are not candidates for the laparoscopic procedure because of obesity, prior abdominal surgery or other problems that make the operation difficult, SAGES explains. In those cases, doctors use techniques involving an endoscope--a long tube--to perform anti-reflux surgery. In one procedure, stitches are made to create folds to strengthen the valve. Another method creates burns on the valve. Scar tissue develops when the burns heal and the lower esophageal sphincter strengthens.
