Reflux Fundoplication Dr Amit D Goswami

What is reflux, what you should know?

By: | Tags: , , , , , | Comments: 0 | October 11th, 2018

It is almost known to all, that, stomach secretes acid. Stomach is the continuation of the food pipe (Esophagus). There is a valve like mechanism (sphincter) at the junction of food pipe and stomach, that normally prevents backward flow of acid into the food pipe. Due to certain factors, the valve becomes defective and it results in backward progression of acid to food pipe or even mouth. This is called reflux (Clinically, called Gastro-esophageal reflux disease or GERD in short).

Causative factors:

Certain conditions can increase the risk of reflux e.g Obesity, Pregnancy, Bulging of upper stomach up through diaphragm (Hiatus Hernia)

Factors that can aggravate reflux are-

  • Smoking
  • Heavy meal at night/ Lying immediately after taking food
  • Alcohol, Caffeine
  • Fried, Spicy or fatty food
  • Taking certain medications like NSAID, Aspirin

 

Presentation:
  • A burning sensation in your chest (heartburn), usually after eating, which might be worse at night
  • Difficulty swallowing
  • Regurgitation (return of previously eaten food to mouth) of food or sour fluids
  • Sensation of a lump in your throat

Sometimes, you may experience-

  • Chronic cough
  • Laryngitis
  • Respiratory difficulty
  • Disturbed sleep

If you develop such symptoms, it is always better to visit your physician.

Diagnosis:

Presentations are usually suggestive. For diagnosis, no extra modalities are required. But, to know the damage or before suggesting surgical managements, some extra investigations like, Upper GI Endoscopy, 24 hours pH Study, Manometry etc, may be required.

Management:

Management of reflux disease needs to be individualized. But it mostly comprises of medical management and life style changes-

Common Life style changes include:

  • Elevate the head end of bed while lying
  • Stop Smoking and alcohol intake
  • Curtail caffeine intake during night
  • Limit meal size and avoid heavy evening meal size
  • Avoid lying down within 2-3 hours of eating

Medical management should always be with Physician’s advice. Irregular and inappropriate over the counter medications can result in recurrent problems

Surgical management:

In intolerant cases, where there has already been a long duration of medical management or there is possibility of the same, there, surgical management is the rule. Nowadays, in the days of minimal access surgery, surgery for reflux (Fundoplication) can be very well performed by laparoscopy (Hole surgery) by experienced laparoscopic surgeon.

Complications:

Narrowing/Shortening of Esophagus and Precancerous changes (Barret’s Esophagus) are two dangerous complications.

So, in case of suggestive Symptoms, don’t delay and meet your physician. Moreover always follow- “Prevention is better than Cure”

If you have any questions or want to consult to learn more about this medical condition, feel free to contact us.

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