All you wanted to know about Antireflux / GERD

Dr. Manish Joshi is a Consultant Surgical Gastroenterologist, GI Oncologist and Advanced Laparoscopic Surgeon at the BGS Global Hospitals, Bangalore. He had earlier served as Head of Surgical Gastroenterology services at St. John’s Medical College Hospital, Bangalore for almost 3 years. 

What is GERD?

Heartburn is a burning sensation caused in chest or throat. This is very common among population and happens when the acid containing contents of the stomach travel back-up into the lower part of esophagus (food pipe).This backward movement of stomach fluids is called reflux.  GERD is a condition where one experiences frequent reflux, where the acid & bile from the stomach moves up into the esophagus* and irritates the esophagus, throat & vocal cords.  GERD can cause long-term swelling and irritation (inflammation) of the esophagus. 

Causes of GERD?

When you swallow food and liquids, they flow down the esophagus to the stomach. A muscle called the lower esophageal sphincter controls the opening between the esophagus and the stomach. The muscle remains tightly closed except when you swallow food preventing the stomach contents from going back into your esophagus. If the ring of muscle is weak or too relaxed or has too much pressure working against it, it doesn’t stay closed and stomach acid and food can flow backwards into your esophagus. The acid can irritate the esophagus and cause GERD symptoms.

Hiatal Hernia

Ahiatal hernia can also cause GERD. Hiatal hernia is a condition in which the opening in your diaphragm lets the upper part of the stomach move up into your chest, which lowers the pressure in the esophageal sphincter. Also, GERD can be a symptom of hiatal hernia. Hiatal hernia might not require treatment unless it is in danger of strangulation or complicated by GERD. 

Symptoms of GERD

Chronic Heartburn

Belching

Difficulty or pain when swallowing

Waterbrash

Chronic irritation in the throat

Bad Breath

Long Term Complications of GERD

Esophagitis : Esophagitis is inflammation in the esophagus. Adults who have chronic esophagitis over many years are more likely to develop precancerous changes in the esophagus

Barrett’s esophagus: Barrett’s esophagus is a condition that develops in some people (about 10%) who have long-term GERD. It is a risk factor for cancer of the esophagus.

Structures: An esophageal stricture happens when your esophagus becomes too narrow. Esophageal strictures can lead to problems with swallowing.

Treatment Options for GERD

Lifestyle Changes

Raise the head of your bed by six inches to allow gravity to help keep the stomach's contents in the stomach. Eat meals at least three to four hours before lying down Eat moderate portions of food and smaller meals. Maintain a healthy weight to eliminate unnecessary intra-abdominal pressure caused by extra pounds. Limit consumption of fatty foods, chocolate, peppermint, coffee, tea, colas, and alcohol

Medication

Take over-the-counter antacid medicines — such as Tums, Rolaids, Maalox, Zantac, Tagamet, Pepcid, and Axid — to relieve esophageal reflux symptoms Prokinetics: Medications that help strengthen the LES and make the stomach empty faster Proton pump inhibitors: Medications that control or eliminate acid.

AntiReflux / GERD Surgery

The most common procedure of this type is called fundoplication. In this surgery, your surgeon will: First repair the hiatal hernia, if one is present. This involves tightening the opening in your diaphragm with stitches to keep your stomach from bulging upward through the opening in the muscle wall. Some surgeons place a piece of mesh in the repaired area to make it more secure. .

Diagnosis of GERD

GERD is diagnosed after your doctor performs a physical exam and reviews your medical history. Tests that may be ordered to confirm the diagnosis of GERD include: 

Esophagoscopy

Barium swallow test

Loss of appetite

Esophageal manometry

Gastric emptying studies

Risk of the surgery

07-medicine

Reactions to Medicines

Breathing Problems

Bleeding, Blood Clots, or Infections

Damage to the Stomach

Gas Bloat

Antireflux / GERD FAQ's

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Ask the Doctor

PreOp-Instructions

  • ON THE DAY BEFORE SURGERY
    Proceed with normal activities, normal diet & Shower
  • AFTER MIDNIGHT BEFORE THE DAY OF SURGERY
    Do not eat or drink anything, including water, candy, gum, mints, Brushing teeth is okay
  • ON THE DAY OF SURGERY
    Do not eat or drink anything Brushing teeth is okay Shower if you did not shower the night before
  • These are typical instructions. Your instructions by your surgeon or doctor may vary.

These are typical instructions. Your instructions by your surgeon or doctor may vary.

PostOp-Instructions

  • ON THE DAY BEFORE SURGERY
    Proceed with normal activities, normal diet & Shower
  • AFTER MIDNIGHT BEFORE THE DAY OF SURGERY
    Do not eat or drink anything, including water, candy, gum, mints, Brushing teeth is okay
  • ON THE DAY OF SURGERY
    Do not eat or drink anything Brushing teeth is okay Shower if you did not shower the night before
  • These are typical instructions. Your instructions by your surgeon or doctor may vary.

These are typical instructions. Your instructions by your surgeon or doctor may vary.

Key Benefits of Laparoscopic / Robotics Surgery

Key Hole Surgery

No Bigger Cuts

Shorter Hospital Stay

Safe & Stress Free Surgery

Short Stay Surgery

Dedicated Doctors

Best-in-Class Process for Best-in-Class Patient Experience

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Consulting

Pre-Surgery Counselling

Surgery

Post-Surgery Counselling

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Dr. Manish Joshi is the Best Gastrointestinal surgeon in Bangalore & India. He is an expert in Advanced Laparoscopic & Robotic Surgical Techniques. His motto is ‘Patient comes first” View Profile.

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Dr Manish Joshi conducts consultation at below locations

BGS Gleneagles Global Hospitals

Apollo Clinic

  • Consulting : 06:00 PM – 07:00 PM (Tues/Thur/Sat)
  • 673/A, Opp. Shriram Samruddhi , Varthur Road, Kundalahalli gate signal, Bengaluru, Karnataka 560066
  • www.apolloclinic.com

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