Anti-reflux Surgery
Gastroesophageal Reflux Disease (GORD) is a chronic condition that affects millions of people worldwide.
This condition occurs when the lower oesophageal sphincter, located the end of the oesophagus (food pipe) becomes weak or relaxes inappropriately, making the stomach acid flow back up into the oesophagus.
This backward flow of acid leads to symptoms such as heartburn, indigestion, regurgitation, and chest pain, which can significantly reduce quality of life.
Advancements in medical technology have made it possible to treat GORD effectively through anti-reflux surgery. One of the most common and effective procedures is the Laparoscopic Nissen Fundoplication, a minimally invasive surgery that offers long-term relief from GORD symptoms.
What is Gastroesophageal Reflux Disease (GORD)?
GORD is more than just occasional heartburn. It is a chronic condition where the stomach acids or bile flow back into the oesophagus, causing inflammation of the oesophageal lining. Over a period of time, this can cause serious complications such as oesophagitis, strictures, and even Barrett’s oesophagus, a condition that can increase the risk of developing oesophageal cancer.
The symptoms of GORD vary from person to person but typically include:
- Persistent heartburn
- Regurgitation of food or sour liquid
- Difficulty swallowing
- The sensation of a lump in the throat
For many, these symptoms can be managed with lifestyle changes and medications. However, surgical intervention may be necessary to provide long-term relief when these measures are insufficient.
Know about anti-reflux surgery
While medicines like proton pump inhibitors (PPIs) or H2 blockers may reduce the production of stomach acid and alleviate symptoms, they do not address the underlying cause of GORD.
Long-term use of these medications has been associated with various side effects, including nutrient deficiencies and an increased risk of bone fractures.
This is where anti-reflux surgery comes into play. Laparoscopic Nissen Fundoplication, a minimally invasive anti-reflux surgery, is considered the gold standard for treating GORD.
This procedure involves repair of hiatus hernia (if present) and wrapping the upper part of the stomach around the lower oesophagus to strengthen the lower oesophageal sphincter, helping to reduce occurence of acid and bile reflux.
Types of anti-reflux surgery
The most common and effective type of anti-reflux surgery is Laparoscopic Nissen Fundoplication. This procedure involves keyhole surgery via five small incisions on the tummy. The procedure is performed under general anaesthesia.
Dr Awad will wrap the top of the stomach (fundus) around the lower oesophagus to make a new valve mechanism, preventing acid and bile from refluxing back into the oesophagus.
Laparoscopic Nissen Fundoplication is preferred over traditional open surgery due to its minimally invasive nature, which results in:
- Faster recovery time: Most patients return to normal activities within a two weeks.
- Reduced post-operative pain: Smaller incisions mean less discomfort after surgery.
- Lower risk of complications: The minimally invasive technique lessens the risk of infection and other surgical complications.
While Laparoscopic Nissen Fundoplication is the most widely performed anti-reflux surgery, other procedures are available depending on the patient’s specific needs.
The procedure: what to expect?
If you are considering Laparoscopic Nissen Fundoplication, it is important to understand what to expect before, during, and after the procedure.
Pre-operative Preparations:
- Consultation: You will have a thorough consultation with Dr Awad to discuss your symptoms, medical history, and the potential benefits and risks of the surgery.
- Pre-surgery tests: You may undergo various tests, such as an endoscopy and pH/manometry study to assess the severity of your GORD and the function of your oesophagus.
During the Surgery:
- The surgery is performed under general anaesthesia and typically takes about 1-2 hours.
- The surgeon makes small incisions in your tummy and inserts the laparoscope and surgical instruments.
- The top of your stomach is wrapped around the lower part of your oesophagus and secured in place, effectively preventing acid reflux.
Post-operative Care:
- Most of the patients can go home as a daycase or stay overnight in the hospital after surgery.
- You will be given specific diet and activity restrictions instructions during your recovery.
- It is common to experience little difficulty swallowing in the first few weeks, but this usually resolves as your body adjusts.
Benefits of anti-reflux surgery
If you undergo anti-reflux surgery, it can significantly improve your quality of life
- Long-term relief from GORD symptoms: Patients who undergo Laparoscopic Nissen Fundoplication often experience complete resolution of their symptoms, allowing them to stop taking medications.
- Reduced risk of complications: By addressing the underlying cause of GORD, surgery can prevent complications such as oesophagitis and Barrett’s oesophagus.
- Improved quality of life: Patients report better sleep, improved digestion, and a general increase in well-being after surgery.
Risks and considerations
As with any surgery, there are risks associated with anti-reflux surgery. These may include:
- Difficulty swallowing (dysphagia), which is usually temporary.
- Bloating and discomfort due to gas buildup (gas-bloat syndrome).
- The surgery may be less effective over time, requiring additional interventions.
However, the risks of surgery are often outweighed by the risks of untreated GORD, which can lead to more serious complications over time.
Is anti-reflux surgery right for you?
Anti-reflux surgery is typically recommended for patients who:
- Have chronic GORD that is not well-controlled with medications.
- Experience significant side effects from long-term medication use.
- Have developed complications from GORD, such as oesophagitis or Barrett’s oesophagus.
If you are considering surgery, it is crucial to consult with a specialist like Dr Sherif Awad, who will assess your symptoms to determine if you are a suitable candidate for Laparoscopic Nissen Fundoplication.
FAQs
Most patients can return to normal activities within 2 weeks, with full recovery typically taking around six weeks.
Yes, medications and lifestyle changes are first-line treatments for GORD, but surgery may be necessary for long-term relief if these are ineffective.
Laparoscopic Nissen Fundoplication has a high success rate (90%), with most patients experiencing significant symptom relief.
Risks include temporary difficulty swallowing, gas-bloat syndrome, and the possibility of needing further surgery in the future.
Consult Dr Sherif Awad today
Anti-reflux surgery, particularly Laparoscopic Nissen Fundoplication, offers a highly effective solution for those suffering from chronic GORD and heartburn.
By understanding the root cause of acid reflux, this surgery can provide long-term relief and improve overall quality of life.
If you are struggling with GORD and are considering surgery, schedule a consultation with Dr Sherif Awad. His minimally invasive anti-reflux surgery expertise can help you achieve lasting relief from acid reflux.
