Gastroesophageal reflux repair
Some suffer from a problem that seems small, but it may cause pain and several problems for the affected person and turn his life into hell. This problem is (GERD) Gastroesophageal reflux disease is a common disease that affects many people of all ages, as it affects adults and children, and several types of GERD vary according to its severity, including simple reflux and severe reflux, and the accompanying symptoms such as burning, difficulty, and swallowing disorders also differ.
Gastroesophageal reflux disease means the reflux of gastric juice from the stomach into the esophagus, and since the cells of the esophagus are not equipped to receive that gastric juice, it causes some problems, such as continuous or intermittent burning in the esophagus and stomach wall, which results in complication from eating foods that are rich in fat or spicy foods. In the following, we will learn about the symptoms of GERD, its causes, and methods of treatment.
First, symptoms of gastroesophageal reflux disease:
1- One of the most common symptoms associated with GERD is a burning sensation in the stomach, which is an annoying and painful feeling for many.
2- Pain and burning in the chest area.
3- Throat pain.
4- Difficult swallowing.
5- Feeling sick.
6- Chronic cough and the possibility of asthma.
7- Change or hoarseness of the voice.
8- Feeling of severe shortness of breath due to the entry of returned fluids from the stomach into the trachea.
All of these symptoms may appear to GERD patients, but not all of them may appear to one patient, as they differ from person to person according to the severity of the reflux.
Second, what are the factors that cause gastroesophageal reflux disease?
The causes of gastroesophageal reflux disease vary, and they are summarized as follows:
1- Obesity and excess weight are one of the most important factors of gastroesophageal reflux disease.
2- Excessive consumption of spicy meals and meals that are high in fat, soft drinks, and alcohol.
3- Excessive eating in general, where the food in the stomach exceeds the need, causing reflux of the esophagus.
4- One of the wrong habits that cause gastroesophageal reflux is binge smoking.
5- Drinking a lot of stimulants such as coffee and tea.
6- Taking some medications, such as painkillers, may cause esophageal reflux problems.
7- Having some stomach diseases such as stomach ulcers or stomach microbes.
8- Mental disorders and continuous stress are also factors of gastroesophageal reflux disease.
9- Hiatal hernia, which requires surgical repair.
10- As a result of the weakness of the lower esophageal sphincter, which may be a genetic problem or as a result of weakness in the muscle itself.
11- Irregular eating.
12- Eating food and then sleeping directly may cause GERD.
13- Hormonal imbalance during pregnancy.
14- Some diseases may increase GERD, such as diabetes.
How is gastroesophageal reflux disease diagnosed?
The disease is diagnosed through an endoscope for the upper part of the digestive system, and the acidity of the esophagus and pharynx is measured by a small device that is installed, and after the result, the treatment steps begin.
How to treat gastroesophageal reflux disease?
The treatment of GERD depends on the severity and frequency of symptoms, meaning that if GERD is mild, it can be treated by eliminating the factors causing it. In some cases, the patient needs to avoid eating spicy and fatty foods. It is also preferable not to eat fried foods and citrus to relieve GERD, other cases may need to stop smoking and reduce drinking coffee, tea, and stimulants in general and drink a lot of water, taking into account the proper sleeping position that reduces GERD by keeping the upper part of the body elevated from the rest of the body.
Drinking some herbs such as ginger and chamomile tea may help reduce and treat the symptoms of GERD, as ginger helps the absorption of stomach acids and empty the contents of the stomach, thus reducing stomach irritation and helping to get rid of the pain.
There are cases that you may need to lose excess weight to get rid of the problem of GERD. But if GERD is in an advanced stage, it may need to take some medications prescribed by a specialist doctor to stop the secretion of gastric acids and reduce stomach burning, and the final treatment may need surgical intervention and a process called the process of reflux repair.
When do we need to perform a reflux repair surgery?
Some cases require surgical intervention and the surgery of GERD repair, including:
1- The presence of a hernia in the diaphragm as we mentioned previously, where the treatment, in this case, calls for surgery to treat the hernia and thus treat the problem of reflux esophagus, where the diaphragm is the protective valve for the muscle between the stomach and the esophagus, which prevents the reflux of gastric juices from the stomach to the esophagus and in the case of a hernia, this leads to muscle weakness and causes the reflux of gastric juices and acids from the stomach to the esophagus, and in severe cases, it leads to ulcers of the esophageal mucosa, which leads to change and damage to cells.
2- In the case of continuous recurrence of symptoms, where the symptoms are burning, pain in the esophagus, and excessive acidity in the esophagus and stomach.
3- In the case of ulcers appearing in the esophagus, which are identified through the endoscope, this case requires surgical intervention immediately to avoid the development of the problem and the incidence of esophageal cancer.
4- In the case of symptoms not related to the digestive system, such as asthma, chronic sinusitis, or pneumonia.
What is the best surgery to repair GERD?
Two surgeries are performed to repair GERD, the Nissen surgery and the Stretta surgery. The Nissen surgery, which is also called the esophageal closure surgery, is performed laparoscopically through small openings in the upper abdomen under the effect of general anesthesia, where the upper part of the stomach is separated and rotated around the lower part of the stomach. The esophagus works to tighten and strengthen the muscle of the esophagus and prevent fluid from returning to the esophagus again. It is considered a strong and effective surgery with minimal complications after the surgery. The surgery lasts for one hour and the surgery is characterized by a high success rate estimated at 90%. Also, the patient was discharged from the hospital on the same day.
While the Stretta surgery differs from Nissen surgery, in which a catheter is inserted into the esophageal sphincter area and then a thorn comes out of the catheter that produces waves that stimulate the muscle and help its growth and as a result, the symptoms decrease and the patient begins to improve, this technique is the latest in this field and It is also done with a laparoscope.
In cases of severe obesity, what is the most appropriate surgery to get rid of obesity and treat GERD together?
It is well known that gastric sleeve is the most famous surgery to lose weight and get rid of obesity, and it is also known that it is an easy process that suits most patients, but in cases of reflux esophagus, gastric sleeve surgery is not the most appropriate because the gastric sleeve surgery reduces the size of the stomach significantly, which increases pressure inside the stomach, which helps to reflux gastric juices and acidity, so the gastric sleeve surgery is not suitable for patients with GERD, but the most appropriate surgery for them is the laparoscopic gastric bypass, which eliminates obesity and reduces pressure inside the stomach, thus treating GERD in a fast way.
