Gastroesophageal Reflux Surgery Health Article

Definition

Gastroesophageal reflux surgery is typically performed in patients with serious gastroesophageal reflux disease that does not respond to drug therapy. Gastroesophageal reflux is classified as the symptoms produced by the inappropriate movement of stomach contents back up into the esophagus. Nissen fundoplication is the most common surgical approach in the correction of gastroesophageal reflux. The laparoscopic method of Nissen fundoplication is becoming the standard form of surgical correction.

Purpose

Gastroesophageal reflux surgery, including Nissen fundoplication and laparoscopic fundoplication, has two essential purposes: heartburn symptom relief and reduced backflow of stomach contents into the esophagus.

Heartburn symptom relief

Because Nissen fundoplication is considered surgery, it is usually considered as a treatment option only when drug treatment is only partially effective or ineffective. Nissen fundoplication is often used in patients with a particular anatomic abnormality called hiatal hernia that causes significant gastroesophageal reflux. In some cases, Nissen fundoplication is also used when the patient cannot or does not want to take reflux medication. Surgery is also more likely to be considered when it is obvious that the patient will need to take reflux drugs on a permanent basis. Reflux drugs, like virtually all drugs, may produce side effects, especially when taken over a period of years.

One of the biggest problems in diagnosing and controlling gastroesophageal reflux disease is that the severity of disease is not directly related to the presence or intensity of symptoms. There is also no consistent relationship between the severity of disease and the degree of tissue damage in the esophagus. When reflux occurs, stomach acid comes into contact with the cells lining the esophagus. This contact can produce a feeling of burning in the esophagus and is commonly called heartburn. Some of the other symptoms associated with this condition include:

• chest pain
• swallowing problems
• changes in vocal qualities