At My Surgical Specialist, our experts specialise in the investigation and treatment of gastro-oesophageal reflux disease (GORD). Our expertise in using latest technology such as the ‘Bravo Capsule‘ allows us to accurately diagnose GORD and provide you with the right treatment for you.
Our expertise in advanced keyhole surgery coupled with essential input from our specialist dieticians enables us to provide you with treatment which is both comprehensive and highly effective.
Common Questions About Acid Reflux
What is acid reflux?
Acid reflux occurs when acid washes out of the stomach and back up the gullet (oesophagus) leading to symptoms which include heartburn. Gastro-oesophageal reflux disease (GORD) is the term given to acid reflux when it occurs regularly, usually at least once a week.
How common is acid reflux?
Acid reflux is very common and most people will suffer from at least a few episodes in their lifetime. GORD however occurs in approximately 1 in 5 people in the UK.
What are the symptoms?
Acid reflux can cause the following symptoms:
-Sensation of burning behind the breast bone (heartburn).
–Regurgitation of food and fluids into the mouth.
–Bad breath & tooth decay.
-In rarer cases acid can reflux into the throat and entwe the windpipe causing wheezing (sometimes misdiagnosed as asthma) and recurrent chest infections.
Persistent acid reflux can lead to long-term inflammation and damage of the oesophagus. Conditions such as Barrett’s oesophagus can develop in this situation. This can be linked to developing oesophageal cancer in the future.
What causes acid reflux?
Most cases of GORD are caused by a poorly working valve in the lower gullet (known as the lower oesophageal sphincter) which normally stops acid from washing back into the oesophagus. Other factors which are associated with GORD include:
-Foods such as chocolate and coffee
How is acid reflux treated?
The first step in treating GORD involves changing your lifestyle and diet to control the reflux and heartburn symptoms. Adding medication to reduce acid reflux symptoms is the next step. If treatment with medication is not successful or you do not wish to be on life-long medication because of some the long-term side effects, then surgery can be considered.
What are the surgical options for GORD?
Surgery for GORD can be considered if your symptoms are severe enough or they do not respond to medication. Surgery can also be considered if you do not want to take life-long medication or suffer side-effects from them.
The traditional procedure undertaken for GORD is a called a ‘laparoscopic fundoplication’. This is a medical term for keyhole surgery which has three stages:
-If you have a hiatus hernia, the stomach is brought back down from the chest cavity to sit in its normal position in the abdomen.
-The gap through which the stomach passed (the hiatus) is repaired to stop the stomach from going back up into the chest
-The top of the stomach is wrapped around the bottom of the gullet (‘fundoplication’) to stop acid refluxing back into the gullet.
Because surgery is undertaken using a keyhole technique, you can be discharged from hospital within 24 hours of your operation. Most people are able to begin undertaking some light normal activities the following day. It takes around 7 to 10 days to recover from the incisions and you will have to go on a special diet for 6 weeks afterwards.
The Linx procedure is a relatively new operation which involves placing an elasticated metal band using a keyhole technique around the lower oesophagus. It has the benefit of being reversible without affecting your ability of having a traditional laparoscopic fundoplication. As this is a newly introduced procedure, the long-term results have not yet been established and not all patients with GORD are suitable for this procedure. Nonetheless, initial results are very positive. You will be able to discuss this option with your surgeon during your consultation.
How successful is surgery for acid reflux?
Anti-reflux surgery is a well established treatment and as such there is a wealth of information on its long-term success. Advances in surgery such as keyhole (laparoscopic) techniques have significantly improved results after surgery. Approximately 9 out of 10 patients achieve long-term satisfaction following their surgery and would recommend it as a treatment to someone who has GORD.
A small number of patients (approximately 20%) find that although symptoms of reflux are significantly reduced, they still need to take anti-acid medication – albeit often at a lower dose than they did previously.
Are there any risks with surgery?
Keyhole anti-reflux surgery is safe and effective and the risks associated with it are small. However no procedure or surgery is risk-free. Complications in the immediate post-operative period can include:
–Infection of the keyhole wounds
–Perforation: The keyhole instruments used during surgery can injure surrounding structures, such as the intestine, bowel and blood vessels. This type of injury is extremely rare, occurring in less than 1% of cases, and can usually be repaired at the time of the operation.
–DVT: A ‘deep vein thrombosis’ is another word for a clot in the leg. These clots can rarely also travel to the lung. We routinely prescribe you special stockings and blood thinning medication following your surgery to reduce the risk of this happening. In addition, because keyhole surgery enables you to return to your daily activities quickly, the risk of developing a DVT is further reduced.
–Difficulty Swallowing: this can occur immediately following surgery usually because of swelling around the bottom of the oesophagus. It is important to follow our special post-operative diet to reduce the risk of this problem whilst the healing process takes place and the swelling in the area settles naturally.
Some of the longer-term problems which may occur include:
–Bloating: A degree of bloating can occur following surgery. The stomach wrap reduces acid reflux from the stomach into the oesophagus. As a result, the wrap also can reduce the amount of gas that you naturally bring up (burping) and can lead to bloating.
–Dumping syndrome: This is a collection of symptoms including diarrhoea, abdominal cramps, sweating, dizziness, headaches and fatigue which can occur after gastric bypass surgery. Some patients complain of dumping syndrome to varying degrees.
–Failure of procedure: Treatment failure occurs in approximately 1 in 10 patients and requires careful investigation to identify its cause.