Gastroesophageal reflux disease (GERD) is a disorder that occurs due to prolonged exposure of the esophagus to stomach acid. Prolonged exposure may be a result of a defective lower esophageal sphincter. Normally lower esophageal sphincter acts like a valve that closes after swallowing. But when LES fails to close adequately, esophagus gets exposed to acid resulting in GERD.
Symptoms of Gastro Esophageal Reflux Disease
GERD may present variably in different individuals but most common symptoms include the following:
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Heartburn that occurs 30 - 60 minutes after eating
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Regurgitation of food that gets worsened on lying flat
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Excessive belching
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Burning sensation in chest
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Pain in chest
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Pain or difficulty while swallowing
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Aspiration - stomach contents refluxed into the airway
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Asthma as a result of aspiration
Diagnosis of Gastro Esophageal Reflux Disease
Diagnosis of GERD involves the following:
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Esophagram
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Upper endoscopy
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Esophageal manometry
Laparoscopic Surgery for Gastro Esophageal Reflux Disease:
Laparoscopic Nissen fundoplication is performed in cases of GERD.
The procedure is performed under general anaesthesia with surgeon making 5 tiny incisions to insert laparoscope and other surgical instruments into the abdomen. A new lower esophageal valve is made by wrapping a two cm portion of the stomach around the lower most portion of the esophagus. This collar is then attached to the tough fibers of the diaphragm. The incisions are closed with sutures or staples, or covered with glue-like bandage.
Advantages of Laparoscopic Nissen fundoplication
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Less pain
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Shorter operative time
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Better cosmetic result
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Shorter hospital stay
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Lower requirement for intravenous narcotics
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Faster recovery
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Negligible risks and complications
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Less chances of wound infection
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High success rate
