Gastroesophageal reflux disease, GERD, is a condition in which stomach juices move up the esophagus from time to time. This causes a burning effect, difficulty in swallowing and occasionally, abdominal pains. A hernia in the diaphragm (hiatal hernia) is a well-known cause of the problem. Initial management involves lifestyle changes and the use of medication but surgery becomes a necessity if a response is not seen. Before undergoing reflux surgery Tx residents need to know several things beforehand.
The operation is popularly known as fundoplication. The main objective is to sew the upper portion of the stomach (also termed fundus) around the lower part of the esophagus. This effectively creates a small tunnel through which the esophagus passes before it enters the muscular layer of the stomach. Effectively, the esophageal sphincter is strengthened. The likelihood of the juices moving back is reduced and so are the symptoms.
It is necessary to undergo adequate preparation before undergoing the operation. The first step is to be evaluated by a doctor on the need to have this operation. The doctor should also determine whether one is fit enough to be operated on. A full blood count and kidney function tests are among the tests that may have to be performed. In case one is on blood thinning medication, the drugs may have to be continued for some time.
The operation may be performed using one of several techniques. The types are broadly classified into open and minimally invasive methods. The open technique is preferred when the patient is either overweight or if they have an abnormally short esophagus. The sphincter in this case is approached through the chest or the abdomen. Minimally invasive techniques include laparoscopic surgery.
When the laparoscopic technique is used, three ports of entry have to be created in the abdominal wall. The ports are used for the insertion of instruments and a camera. The camera helps to capture the images from the surgical field and projects them onto a monitor. The ports of entry that are used are significantly smaller than those that are used in the open procedure. The side effects associated with laparoscopy are fewer.
The recovery period required is largely dependent on the method that is employed. The open technique is performed through large incisions hence requires that one remains hospitalized for a number of days before being allowed home for full recovery. Smaller incisions are require in the case of laparoscopic surgery and as such less time is needed for recovery. On average, patients require 2 to 3 weeks to resume normal routine.
During the initial days and weeks following the operation, the food that is eaten should be carefully selected. It should be soft enough and eaten in small quantities. Chewing should be through to ensure that it does not interfere with healing process taking place at the lower esophageal sphincter. Another important precaution that needs to be undertaken is the avoidance of strenuous physical activity during the healing period.
Many of the patients who have surgery experience a huge improvement. A few of them do not. In such patients, the symptoms may either persist or worsen. Such include belching, difficulty in swallowing and flatulence among others. Long term management with antacid drugs becomes a necessity in this instance. If the drugs fail to yield the desired results, another operation may have to be performed.
The operation is popularly known as fundoplication. The main objective is to sew the upper portion of the stomach (also termed fundus) around the lower part of the esophagus. This effectively creates a small tunnel through which the esophagus passes before it enters the muscular layer of the stomach. Effectively, the esophageal sphincter is strengthened. The likelihood of the juices moving back is reduced and so are the symptoms.
It is necessary to undergo adequate preparation before undergoing the operation. The first step is to be evaluated by a doctor on the need to have this operation. The doctor should also determine whether one is fit enough to be operated on. A full blood count and kidney function tests are among the tests that may have to be performed. In case one is on blood thinning medication, the drugs may have to be continued for some time.
The operation may be performed using one of several techniques. The types are broadly classified into open and minimally invasive methods. The open technique is preferred when the patient is either overweight or if they have an abnormally short esophagus. The sphincter in this case is approached through the chest or the abdomen. Minimally invasive techniques include laparoscopic surgery.
When the laparoscopic technique is used, three ports of entry have to be created in the abdominal wall. The ports are used for the insertion of instruments and a camera. The camera helps to capture the images from the surgical field and projects them onto a monitor. The ports of entry that are used are significantly smaller than those that are used in the open procedure. The side effects associated with laparoscopy are fewer.
The recovery period required is largely dependent on the method that is employed. The open technique is performed through large incisions hence requires that one remains hospitalized for a number of days before being allowed home for full recovery. Smaller incisions are require in the case of laparoscopic surgery and as such less time is needed for recovery. On average, patients require 2 to 3 weeks to resume normal routine.
During the initial days and weeks following the operation, the food that is eaten should be carefully selected. It should be soft enough and eaten in small quantities. Chewing should be through to ensure that it does not interfere with healing process taking place at the lower esophageal sphincter. Another important precaution that needs to be undertaken is the avoidance of strenuous physical activity during the healing period.
Many of the patients who have surgery experience a huge improvement. A few of them do not. In such patients, the symptoms may either persist or worsen. Such include belching, difficulty in swallowing and flatulence among others. Long term management with antacid drugs becomes a necessity in this instance. If the drugs fail to yield the desired results, another operation may have to be performed.
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