If lifestyle changes or medication prove ineffective, a type of minimally invasive surgery called fundoplication may be an option for poorly controlled acid reflux or gastro-oesophageal reflux disease.
More than causing a burning feeling in the chest, acid reflux or gastro-oesophageal reflux disease (GERD) can lead to lasting damage to the oesophagus. The condition is caused when the acidic contents of the stomach flow back up into the passageways of the throat. Apart from typical symptoms such as heartburn and difficulty swallowing (dysphagia), those with GERD may also develop hoarseness, chronic throat-clearing, sore throat, wheezing, coughing and even asthma.
The first step in treating GERD is lifestyle and behavioural changes, such as weight loss, avoidance of trigger foods, quitting smoking and sleeping with your head elevated. Medications may also be prescribed to reduce the acidity of the stomach; however, they have long-term side effects, such as an increased risk of osteoporosis.
Treating GERD surgically
For people suffering from severe GERD and who wish to avoid lifelong acid suppression medication, minimally invasive surgery is an option. The procedure is called fundoplication.
It involves wrapping a portion of the stomach (the upper curve of the stomach, called the fundus) around the bottom of the oesophagus and sewing it into place so that the valve between it and the stomach is strengthened, thus preventing the backflow of gastric acid. This type of surgery helps to reduce GERD symptoms and allows the oesophagus to heal from long-term acid damage.
The surgery is most commonly done using laparoscopes — thin, tube-like devices through which a camera and other tools can be inserted. This minimally invasive surgical technique has several advantages over open surgery:
- Surgical incisions are small (less than 1 cm), leading to smaller scars
- Results in less pain
- There is a lower risk of infections
The procedure can double up to repair a hiatal hernia, a common complication of GERD. This is when a small portion of the stomach pushes upward through the diaphragm. Because it is minimally invasive, patients only need to stay in hospital for several days. Recovery is also faster, so most people can return to work within a week or two.