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Gastroesophageal Reflux Disease

By John  W. Shaw, M.D.

 

Repeated bouts of heartburn, sour-tasting fluid in your throat, difficulty swallowing – all are classic symptoms of a common health problem called gastroesophageal reflux disease, or GERD (also known as reflux disease).  The heartburn caused by GERD may strike after you eat a large meal or when you bend over or lie down.  GERD can sometimes be controlled with simple lifestyle changes and medication.  If your symptoms persist, surgery may offer more lasting relief from GERD.

 

What Causes GERD?

When you have GERD, you often have a burning feeling (heartburn) in the middle of your chest.  This is caused by acid that escapes from your stomach through a weakened one-way valve near the top of your stomach.  The acid can travel backward as far as your throat.  Smoking, caffeine, and alcohol all increase the level of acid in your stomach, causing even more heartburn.

 

Lifestyle Changes

Simple lifestyle changes, such as avoiding spicy, fried, or fatty foods and losing any extra weight can often help reduce the symptoms of GERD.  Being careful about bending over especially after eating may help you feel better, as can avoiding food within four hours of bedtime.  Sleeping with the head of your bed raised and exercising regularly may also help relieve your symptoms.

 

Medical Treatment

GERD is sometimes treated with over-the-counter antacids that you can buy without a prescription.  If antacids don’t provide enough relief, you doctor may prescribe other medication to help with digestion.  Some of these medications may be used together.  Your doctor will tell you which combination is best for your symptoms.  If you are having trouble swallowing, your esophagus may be stretched in a medical procedure.

 

Laparoscopic Surgical Procedure

During this procedure, the doctor re-creates your lower esophageal sphincter (LES) by wrapping the very top of your stomach around the esophagus.  The surgery usually lasts from 2 to 4 hours.  Laparoscopic surgery is performed through several small incisions instead of a single long one, as in the traditional open procedure.  As a result, there is less pain, a quicker recovery time, a shorter hospital stay, and lower risk of infection.

 

Most people go home 1 to 3 days after laparoscopic surgery and return to work in 1 to 2 weeks.  Because no muscles are cut and only small incisions are made, you are likely to experience less postoperative pain than from open surgery.  You may be able to start on a liquid diet soon after surgery.  When your small incisions heal, the scars may be nearly invisible.  Best of all, you’ll be able to eat without the pain and discomfort that GERD can cause.

 

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