The gastro-oesophageal reflux (GERD) is a chronic disease that affects millions of people worldwide. While many people are able to control their symptoms with over-the-counter or prescription medications, there are those who suffer from persistent symptoms, such as chronic heartburn, chest pain and swallowing difficulties, that do not improve with conventional treatments. For these patients, surgery may offer a lasting and effective solution.
What is gastro-oesophageal reflux disease (GORD)?
GERD occurs when stomach contents, including stomach acid, back up into the oesophagus, causing irritation to the oesophageal lining. Over time, this constant flow of acid can cause permanent damage, such as the oesophagitis (inflammation of the oesophagus) or even increase the risk of developing Barrett's oesophagus, a pre-cancerous condition.
When to consider surgery?
While medications such as proton pump inhibitors (PPIs) can reduce acid production and alleviate symptoms, they do not address the underlying cause of reflux: the weakened immune system. lower oesophageal sphincter (LES)which is the valve between the oesophagus and the stomach. For people whose reflux does not improve with medication or for those who wish to avoid long-term use of drugs, surgery is a viable option.
Advanced surgical options for GORD
- Nissen fundoplicationThis surgery involves wrapping the upper part of the stomach around the oesophagus to strengthen the LES and prevent gastric acid from backing up into the oesophagus. It is one of the most common and effective surgical treatments for chronic GERD.
- LINX systemThis modern alternative uses a ring of small magnetic beads that is placed around the LES. The LINX system allows patients to swallow normally, but prevents acid from backing up into the oesophagus. Unlike fundoplication, the LINX system is reversible and less invasive.
Benefits of surgical treatments
Patients who undergo surgical treatments for reflux often experience a significant improvement in their quality of life. Most report a dramatic reduction in reflux symptoms, such as heartburn and pain, and many can reduce or completely eliminate their dependence on medications. In addition, surgery can help prevent serious complications, such as chronic oesophagitis and Barrett's oesophagus.
Is surgery right for everyone?
Not all patients with GORD are ideal candidates for surgery.