GERD, or gastroesophageal reflux disease, is a digestive disorder that affects millions of people worldwide. It occurs when stomach acid flows back into the esophagus, causing discomfort, pain, and other symptoms. While many people manage GERD with lifestyle changes and medication, surgery may be necessary for others. In this article, I will discuss the benefits, risks, and recovery of GERD surgery.

Understanding GERD and its symptoms

GERD is a chronic condition that occurs when the lower esophageal sphincter (LES) fails to close properly. The LES acts as a valve between the esophagus and stomach, preventing food and stomach acid from flowing back into the esophagus. When the LES is weak or relaxed, it allows stomach acid to flow back into the esophagus, causing irritation and inflammation.

Symptoms of GERD include heartburn, chest pain, difficulty swallowing, regurgitation of food or liquid, and a sour or bitter taste in the mouth. These symptoms can interfere with daily activities, affect sleep quality, and reduce overall quality of life.

When is GERD surgery necessary?

GERD surgery is usually considered when lifestyle changes and medication are ineffective in managing symptoms. In some cases, surgery may be recommended for people who cannot tolerate medication or who have complications from GERD, such as Barrett’s esophagus or esophageal stricture.

Before recommending surgery, your doctor will perform tests to confirm a diagnosis of GERD and evaluate the severity of your symptoms. These tests may include an upper endoscopy, esophageal manometry, and pH monitoring.

Different types of GERD surgery

There are two main types of GERD surgery: laparoscopic anti-reflux surgery and esophageal surgery for GERD.

Laparoscopic anti-reflux surgery involves wrapping the upper part of the stomach around the LES to strengthen the valve and prevent acid reflux. This surgery is performed using small incisions and a laparoscope, a thin tube with a camera and surgical instruments attached.

Esophageal surgery for GERD involves repairing or replacing the damaged esophagus. This surgery may be recommended for people who have severe complications from GERD, such as Barrett’s esophagus or esophageal stricture.

Benefits of GERD surgery

GERD surgery can provide long-term relief from symptoms and improve overall quality of life. Studies have shown that laparoscopic anti-reflux surgery can improve symptoms in up to 90% of people and reduce the need for medication.

Other benefits of GERD surgery include:

• Reduced risk of complications from GERD, such as Barrett’s esophagus or esophageal stricture
• Improved sleep quality
• Improved ability to eat and drink without discomfort
• Reduced risk of developing esophageal cancer

Risks and complications of GERD surgery

Like any surgery, GERD surgery carries some risks and potential complications. These may include:

• Bleeding
• Infection
• Adverse reaction to anesthesia
• Difficulty swallowing
• Gas bloat syndrome (feeling bloated or full after eating)
• Failure of the surgery to provide relief

While these risks are rare, it is important to discuss them with your doctor before deciding to undergo GERD surgery.

Preparing for GERD surgery

Before undergoing GERD surgery, your doctor will provide instructions on how to prepare for the procedure. This may include:

• Stopping certain medications, such as blood thinners, before the surgery
• Fasting for a certain period of time before the surgery
• Arranging for someone to drive you home after the surgery

You may also be asked to undergo additional testing, such as blood tests or imaging scans, to ensure that you are healthy enough for surgery.

What to expect during GERD surgery

GERD surgery is typically performed under general anesthesia and takes between 2-4 hours, depending on the type of surgery. During the procedure, your surgeon will make small incisions in your abdomen and insert a laparoscope to view the area. They will then wrap the upper part of your stomach around the LES or repair or replace the damaged esophagus.

After the surgery, you will be taken to a recovery room to be monitored for any complications. You may need to stay in the hospital for a few days to recover, depending on the type of surgery.

Recovery after GERD surgery

Recovery after GERD surgery varies depending on the type of surgery and individual factors, such as age and overall health. In general, you can expect to:

• Experience some pain and discomfort for a few days
• Have a restricted diet for a few weeks
• Resume normal activities gradually over several weeks
• Follow up with your doctor regularly to monitor your progress

Your doctor will provide specific instructions on how to care for your incisions, manage pain, and resume normal activities.

Lifestyle changes after GERD surgery

Following GERD surgery, it is important to make lifestyle changes to reduce the risk of acid reflux and maintain the benefits of the surgery. These may include:

• Eating smaller, more frequent meals
• Avoiding trigger foods, such as caffeine, alcohol, and spicy foods
• Maintaining a healthy weight
• Elevating the head of the bed to reduce acid reflux while sleeping
• Quitting smoking

Your doctor may also recommend ongoing medication to manage acid reflux.

Alternative treatments for GERD

While surgery may be necessary for some people with GERD, there are also alternative treatments to manage symptoms. These may include:

• Lifestyle changes, such as avoiding trigger foods and losing weight
• Medications, such as proton pump inhibitors and H2 blockers
• Endoscopic treatments, such as radiofrequency ablation and endoscopic suturing

Conclusion

GERD surgery can provide long-term relief from symptoms and improve overall quality of life. While the decision to undergo surgery should be made in consultation with your doctor, it is important to understand the benefits, risks, and recovery of the procedure. By making lifestyle changes and following your doctor’s instructions, you can maintain the benefits of surgery and reduce the risk of acid reflux.

If you are considering GERD surgery, North Texas Surgical Specialists can help you understand your options and provide expert care. With 17 locations in Texas, we are committed to providing the highest quality of care to our patients.