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All about gastroesophageal reflux disease (GERD, acid reflux) causes of gastroesophageal reflux disease symptoms of gastroesophageal reflux disease complications of gastroesophageal reflux disease diagnosis of gastroesophageal reflux disease treatment of gastroesophageal reflux disease GERD medications surgery for gastroesophageal reflux disease prevention of gastroesophageal reflux disease gastroesophageal reflux disease in infants hiatal hernia Articles in peptic disorders (stomach disease) - gastritis Barrett's esophagus indigestion (dyspepsia) cyclic vomiting syndrome (CVS) Zollinger-Ellison syndrome gastroparesis hiatus hernia peptic ulcer gastroesophageal reflux disease (GERD)

What surgery treats gastroesophageal reflux disease?

Surgery is indicated for a small group of patients with GERD. The most common indication for surgery is the failure of medical therapy to adequately relieve symptoms of GERD. Some patients are unable to tolerate medical therapy due to side effects from the medications themselves. Other patients experience complications of GERD such as scarring, bleeding, or respiratory symptoms that are sometimes best treated with an operation. There is currently debate over whether young

adults with significant GERD symptoms should be considered for surgery even if they obtain adequate relief from medical therapy.

The standard surgical treatment, sometimes preferred over longtime use of medication, is the Nissen fundoplication. The upper part of the stomach is wrapped around the LES to strengthen the sphincter and prevent acid reflux and to repair a hiatal hernia. The procedure is often done laparoscopically. During fundoplication, any hiatal hernial sac is pulled below the diaphragm and stitched there. In addition, the opening in the diaphragm through which the esophagus passes is tightened around the esophagus. Finally, the upper part of the stomach next to the opening of the esophagus into the stomach is wrapped around the lower esophagus to make an artificial lower esophageal sphincter. All of this surgery can be done through an incision in the abdomen (laparotomy) or using a technique called laparoscopy. During laparoscopy, a small viewing device and surgical instruments are passed through several small puncture sites in the abdomen. This procedure avoids the need for a major abdominal incision.

The aims of surgery for GERD are to correct any hernia which might exist and to wrap a portion of the stomach around the esophagus, thus creating a new valve mechanism to prevent reflux. If complications of GERD exist, such as scarring or ulcer formation, these are also corrected at the same time. The likelihood of having a successful operation that relieves symptoms of GERD sufficiently so that no medications are necessary is about 95%.

More information on gastroesophageal reflux disease (acid reflux, GERD)

What is gastroesophageal reflux disease (acid reflux)? - Gastroesophageal reflux disease (GERD) is a condition in which stomach contents, including acid, back up (reflux) into the esophagus, causing inflammation and damage to the esophagus.
What causes gastroesophageal reflux disease? - Gastroesophageal reflux disease is often the result of conditions that affect the lower esophageal sphincter (LES). Dietary and lifestyle choices may contribute to GERD.
What are the symptoms of gastroesophageal reflux disease? - Heartburn, also called acid indigestion, is the most common symptom of reflux. The most common symptoms in children are repeated vomiting, coughing, and other respiratory problems.
What're the complications of gastroesophageal reflux disease? - Chronic gastroesophageal reflux disease can lead to a number of serious problems, such as bleeding ulcers in the esophagus, and scarring leading to narrowing of the esophagus.
How is gastroesophageal reflux disease diagnosed? - Useful diagnosing methods include barium swallow X-rays, esophageal manometry, esophageal pH monitoring and EGD.
What're the treatments for gastroesophageal reflux disease? - Doctors recommend lifestyle and dietary changes for most people with GERD. Lifestyle modifications are a key component in the management of GERD and should be incorporated into all treatment stages.
What GERD medications treat gastroesophageal reflux disease? - Antacids remain the drugs of choice for quick relief of symptoms associated with GERD. H2-Receptor blockers are indicated for the prevention and relief of heartburn, acid indigestion and sour stomach.
What surgery treats gastroesophageal reflux disease? - Surgery is indicated for a small group of patients with GERD. The standard surgical treatment, sometimes preferred over longtime use of medication, is the Nissen fundoplication.
How to prevent gastroesophageal reflux disease with lifestyle? - A correct life style is effective to prevent the symptoms of GERD. Avoid foods that promote opening of the esophageal sphincter and increase acid reflux.
Gastroesophageal reflux disease in infants and children - Infants are more likely to have the lower esophageal sphincter (LES) relax when it should remain shut. Infants are easier for the stomach contents to reflux up into the esophagus.
What is hiatal hernia? - A hiatal hernia is named for the hiatus, an opening in the diaphragm between your chest and your stomach. There are two types of hiatal hernias. 
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