Question from: 2/9/98

"About a year ago I was diagnosed with esophageal reflux. The symptoms are quite bothersome if I don't take medicine every day. The pills are all very expensive and I worry about long-term side effects. Are there any other alternatives?"

by G. Steven Webb, M.D.

and Ken Hagan, M.D.

General Surgery Group, P.A.

Answer: Gastroesophageal reflux ("heartburn") is an extremely common condition affecting many Americans. Usually, the symptoms are intermittent in nature and can be controlled with medication. However, if symptoms persist despite continued treatment or complications arise, surgical intervention can be contemplated.

If the usual attempts to control your gastroesophageal reflux disease (GERD) do not offer relief, you may be candidate for laparoscopic fundoplication. This surgery combines today’s technology with a surgical procedure that has been used safely for over forty years and has a 95% satisfaction rate.

The surgery is done using a laparoscope, which allows the doctor to see clearly into your abdomen. During the surgery the surgeon re-creates the one-way valve where the esophagus (the tube that food travels through) meets the stomach. This one-way valve usually prevents the acidic contents of the stomach from refluxing back up into the esophagus. When this valve is dysfunctional, reflux and the symptoms associated with it can occur.

The doctor may also tighten the opening of the diaphragm through which the esophagus passes. If this opening is too large (hiatal hernia), it is often associated with reflux disease. This tightening is performed with a few sutures (stitches).

Most people go home from the hospital within one to two days after laparoscopic surgery and return to work in approximately two weeks. Because no muscles are cut and only small laparoscopic incisions are made, there is usually much less pain than with open surgery.

You are able to begin a liquid diet soon after surgery (usually within the first day). When the small incisions heal, the scarring is almost imperceptible.

Following the surgery you are able to eat without the pain and discomfort that gastroesophageal reflux can cause, In addition, the medications can often be discontinued.

G. Steven Webb, M.D.

Ken Hagan, M.D.

General Surgery Group, P.A.


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