Gastroesophageal Reflux Disease (GERD)
There are certain diseases of the esophagus that are not cancers but do require surgical attention. These diseases include achalasia, gastroesophageal reflux disease (GERD) and esophageal leiomyoma.
- A common chronic disease in which stomach acid comes up into the esophagus causing damage to the lining of the esophagus resulting in symptoms.
- The lower esophageal sphincter (LES) separates the stomach from the esophagus.
- When the LES is “too relaxed,” acid that is produced in the stomach can go into the esophagus.
- In addition to uncomfortable symptoms, GERD can cause damage to your lungs and esophagus. Excessive esophageal acid exposure can cause esophagitis, Barrett’s esophagus, reflux strictures (narrowing of the esophagus) and esophageal cancer.
- GERD can also be associated with hiatal hernias.
- Occasional chest pain
- A hoarse voice
- Cough in the morning that gets better throughout the day that is a result of acid going into the lungs at night
Treatment for GERD
- Lifestyle changes:
- Since different foods can cause reflux in different people, you should keep a food log to help identify those food groups that worsen your reflux symptoms. These foods should then be eliminated from your diet.
- Other ways to decrease acid from going into the esophagus is to never eat while laying down and never eat within 2 hours of going to sleep. We also advise patients to use pillows to elevate their heads while sleeping in order to decrease the amount of acid that goes into the esophagus when they are sleeping.
- Maintaining a healthy weight.
- Avoid caffeine and alcohol as both can relax the LES.
- Quit smoking as nicotine relaxes the LES.
- Proton pump inhibitors such as omeprazole, esomeprazole, pantoprazole, lansoprazole, and rabeprazole are the mainstay of pharmaceutical treatment for GERD. There are other options for medical management of GERD. The best medicine for treatment of your GERD should be decided by you and your gastroenterologist.
- Laparoscopic Fundoplication:
- The goal of a surgery is to wrap your stomach around your esophagus. This is known as a fundoplication.
- This helps decrease the amount of stomach acid that can pass into your esophagus.
- With state of the art equipment, we perform this minimally-invasive surgical procedure with cameras and fine instruments utilizing five 1-inch incisions.
- Patients generally go home within 24-36 hours of surgery.
- There are several types of fundoplications, with the Nissen fundoplication being one of the more common procedures performed for GERD. The type of surgical procedure that best suits your disease will be decided by you and the surgeon.
At White Plains Hospital we have a fully staffed Thoracic Surgery Service that includes board-certified thoracic surgeons, anesthesiologists, pulmonologists, gastroenterologists and critical care intensivists. In addition, we have a staff of highly trained nurses, respiratory therapists, nutritionists, physical therapists, case managers and social workers that work in-sync with your surgeon to provide great care for you when you are recovering from your surgery.
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