Metro Bariatrics - Amir Moazzez MD, FACS

Gastroesophageal Reflux Disease (GERD)

General: GERD or reflux or heartburn is the condition when acid and/or bile juices from the GI tract backwash into the esophagus causing the burning sensation. The acidic juices are secreted in the stomach. These juices do not harm the stomach because of the thick muscular lining. However, when these juices reflux back onto the esophagus, patients have a burning sensation in the middle of the chest because the esophageal lining is very thin and sensitive. The junction between the esophagus and stomach (GE junction) serves as a “ball valve.” This allows food/liquids to pass from the esophagus to the stomach, and not allow stomach contents to reflux back into the esophagus. Patients who complain of heartburn have a problem with this anatomical location.

Signs and Symptoms: Heartburn or reflux begins between the lower aspect of the breast bone. This may feel like burning or knowing pain. The pain may travel up the chest to the back of the throat with a sour taste. The fluid may even irritate the windpipe and vocal cords causing hoarseness or asthma attacks.

Diagnosis: History and Physical

Treatment:

If all these fail to manage your heartburn symptoms then you should consider consultation for anti-reflux surgery.

Surgical Option: Laparoscopic Nissen Fundoplication

This surgery reconstructions the “ball-valve” of the GE junction to prevent acid juices from refluxing into the esophagus from the stomach and allowing normal swallowing of food. The surgery consists of using 5 small 1cm incisions of the upper abdomen. We perform a 360 degree wrap of stomach around the lower esophagus. If there is a hiatal hernia, this will be reduced and repaired.

Post-operatively: Patients have minimal pain and are started on a liquid to soft diet on the following day. Discharge is usually the next day as tolerated. Patients go home on a soft diet and liquid pain medications. Activity levels are increased and encouraged as tolerated (avoid heavy lifting). Our patients follow up with us in the office after surgery, and are encouraged to call us at any time with questions.