Reflux disease is a common problem. The common symptoms are heartburn, feeling of acid regurgitation into mouth, oral cavity problems, breathing difficulty, headache etc. With our changing lifestyle, especially in the urban population due to high stress levels, irregular meal times, eating outside food frequently, the incidence of reflux disease is now felt to be over 20-25%. The common treatment is medication to suppress the acid in the stomach. When reflux is so bad that it cannot be controlled even if acid suppressant medication or medication cannot be stopped after long term, either endoscopic or surgical treatment should then be considered. An upper GI endoscopy should be done at least once if reflux symptoms are not controlled within a few weeks of starting medication.
The causes of reflux disease include weak sphincter mechanism (valve)at the upper part of the stomach that prevents acid regurgitation. Sometimes this is associated with a hiatal hernia.
The gold standard surgery for reflux disease is Laparoscopic Nissen Fundoplication with or without repair of the hiatal hernia. In the surgery the sphincter mechanism is tightened by wrapping the fundus or the stomach at the junction of stomach with the food pipe. The wrap should not be too tight to prevent swallowing difficulty.
Most of the patients only need couple of days stay in hospital after laparoscopic anti- reflux surgery. The resolution of reflux symptoms is immediate.
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