Gastro-oesophageal reflux disease is a common condition affecting millions of people worldwide. In healthy individuals, there is a very effective one-way valve mechanism between the gullet and the stomach, which prevents gastric acid from entering the gullet. Due to a variety of factors, the valve mechanism can fail, which will lead to the lining of the gullet being exposed to acid and the patient experiencing the symptom of heartburn.
The risk factors for developing GERD are:
What are the related symptoms of GERD?
Common GERD symptoms may include:
Seek medical treatment if you have chest pain, especially if you experiencing shortness of breath, or jaw or arm pain as these may also be symptoms of a heart attack. See your doctor if you experience severe GERD symptoms or if over the counter heartburn medication fails.
If left untreated, GERD can lead to the following complications:
The diagnosis of GERD can be made based on the history of the patient and if necessary, performing gastroscopy or a 24 hr pH (acid) monitoring test. Not all patients will need a gastroscopy, definite indications for a gastroscopy are:
What are the treatment options for GERD?
The mainstay of GERD treatment is medical therapy with a PPI (proton pump inhibitor: a type of drug highly effective in suppressing the secretion of gastric acid). Most patients will experience complete relief of their heartburn after initiating PPI therapy. Dr Cooper may recommend surgery for the following scenarios:
Anti-reflux surgery (if done for the correct indications) can produce excellent long- term relief of heartburn without the hassle and expense of taking daily medication. There are a variety of surgical procedures available to treat GERD of which the "Nissen fundoplication" is the most widely used.
All of the currently available procedures are based on the same principle: the restoration of the normal barrier to gastric acid reflux while exposing the patient to the minimum risk of morbidity and mortality. Except in the presence of a clear contra-indication, all anti-reflux procedures should be done in a minimally invasive/laparoscopic manner.
Risks or complications following anti-reflux surgery include: