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Find out all you need to know about GORD Surgery.
Some answers to questions we are often asked.
Most people have had heartburn or acid reflux at some time in their life. Acid reflux occurs when contents of the stomach move upwards in to the gullet past the lower oesophageal sphincter. Acid reflux may damage the lining of the gullet. This whole process is called gastro-
The Lower Oesophageal Sphincter (LOS) is a ring of smooth muscle tissue, which acts as a two way valve between the stomach and the gullet. It allows food in to the stomach and prevents movement of the stomach contents in to the gullet. A weak LOS could lead to acid reflux. In some people weak LOS is associated with a hiatus hernia. The LOS also allows vomiting and belching as a normal physiological response.
When the LOS relaxes or closes partially, reflux can occur. Infrequent reflux can be annoying but does not lead to any harm. However, frequent reflux can cause serious damage to the gullet affecting health and quality of life. Frequent reflux of acid can damage the gullet lining causing oesophagitis. Rarely, recurrent oesophagitis can lead to a stricture (narrowing). Very small percentage can develop a pre-
In addition to a faulty LOS, GORD can be aggravated by:
• Delayed gastric emptying (food stays in the stomach for longer before it is passed in to the small bowel).
• Impaired oesophageal function (weaker gullet muscle function which pushes food forward in to the stomach)
• Low production of saliva (important in neutralising stomach acid)
• Smoking, excessive caffeine and alcohol consumption
What is the alternate option?
Surgery is designed to control acid reflux and get you off medication. The only other option would be to continue medication to control acid reflux.
Do I need any tests?
We usually perform the following tests before deciding your suitability for laparoscopic fundoplication.
Allows inspection of the oesophagus, the stomach and the duodenum (first part of small bowel). This is done with the patient sedated or by anaesthetising back of the throat with local anaesthetic spray. This technique allows your doctor to identify complications of GORD and obtain samples from the gullet and the stomach lining.
This is done (under local anaesthetic spray) by passing a fine probe via the nostril in to the gullet. This test is designed to assess gullet muscular movements.
24 hour Oesophageal pH monitoring:
This test is done by passing a very fine probe in to the gullet, which is left for 24 hours. This test is carried out immediately after the manometry test. The probe is connected to a small machine which looks like a Walkman. This allows to measure acid reflux in to the gullet. You will be asked to return after
24 hours for removal of the probe:
All these tests are carried out as out-
What is a Hiatus Hernia?
A Hiatus hernia occurs when part or whole of the stomach protrudes in to the chest through a weakness in the diaphragm. There are two types of Hiatus hernia: sliding or rolling. If you have a hiatus hernia, your surgeon may repair it during fundoplication.
What is the treatment?
The majority who suffer from GORD respond well to life style changes. If symptoms persist long term medication may be required. In some patients, surgery may be recommended because medication and life style changes have not been effective. Surgery may also be indicated in patients who do not wish to take long term medication because of side effects.
Surgery is designed to provide a cure for GORD. The name of the surgery is referred to as a laparoscopic fundoplication. The aim of the surgery is to create an artificial valve to prevent the stomach contents from moving upwards in to the gullet.
Do I need an operation?
You may need an operation to control acid reflux if you have any of the following:
• Oesophagitis despite being on high dose medication
• Persistent symptoms despite being on regular medication prescribed by your doctor
• Side effects from medication
• You do not wish to continue taking long term medication.
We’re here to help with any questions you have about any of the procedures we offer.
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