Doctors recommend surgery for acid reflux problems when medications and changes in diet do not relieve frequent acid reflux and heartburn. Acid reflux occurs because of an improperly working muscle valve in the esophagus. The valve normally opens when food enters the stomach and closes to prevent stomach acid from backing up into the esophagus. When the valve does not close tightly, it results in acid reflux that causes heartburn, the burning sensation in the upper chest and throat that may also include a bitter taste in the back of the mouth.
Identification
Many people experience heartburn occasionally. Some people have it two or more times a week, which is considered gastroesophageal reflux disease, or GERD, according to the National Digestive Diseases Information Clearinghouse. The esophageal valve has become permanently weakened. Patents can often prevent frequent acid problems through over-the-counter or prescription medications that neutralize stomach acid or reduce acid production. An adjusted diet may also reduce symptoms. Doctors advise patients to avoid foods that cause heartburn, which may include fatty or spicy foods, tomato-based products, onions, garlic, chocolate, caffeine or carbonated drinks. Foods that trigger the problem may depend on the individual.
Considerations
When diet and medication do not prevent acid reflux, surgery becomes an option. Doctors also recommend surgery if patients suffer from bleeding or damage to the lining of the esophagus from frequent acid reflux, according to the American College of Gastroenterology. Patients consult with a gastroenterologist and a surgeon about the surgical techniques available. Several methods can repair the area between the stomach and esophagus to prevent acid reflux.
Function
Fundoplication, the standard surgical treatment, repairs tissue in the area by wrapping the upper part of the stomach around the esophageal valve, called the lower esophageal sphincter. This strengthens the valve. In a new technique, known as laparoscopic Nissen fundoplication, surgeons cut small incisions in the abdomen. They insert a laparoscope, or tube, through the incision. The laparoscope connects to a tiny camera so surgeons have a magnified view of the patient's internal organs, according to the Society of American Gastrointestinal and Endoscopic Surgeons. This makes it easier to perform the wrapping procedure.
Benefits
Acid reflux problems usually disappear or are reduced from the surgery. Laparoscopic surgery has advantages over other surgical methods. Patients have reduced postoperative pain and shorter hospital stays to return to work or other activities faster than other surgeries. However, some patients may not be candidates for the surgery because of obesity, a prior history of abdominal surgery or bleeding problems during surgery. They can still choose other methods that may work effectively.
Options
Doctors can use a tube-like instrument, called an endoscope, that they insert to put stitches in the lower esophageal sphincter to create folds in the area that strengthen the muscle valve to prevent acid reflux. Another surgical technique involves using electrodes that create burns on the valve. Scar tissue develops when the burns heal to toughen the muscle valve and prevent acid reflux.
