When do I need surgery for Gastroesophageal Reflux?

Gastroesophageal reflux disease happens when the acid in the stomach returns to the esophagus more often than expected , which can cause symptoms of heartburn, burning and even chest pain . This leads to a worsening of the quality of life, which can disrupt the day-to-day.

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Most of the time, the symptoms can be well controlled with the use of medication and with an improvement in lifestyle . It is important to have a balanced diet , weight control , avoid excess alcohol, cigarettes and caffeine (present in coffee, soft drinks, teas, energy drinks, chimarrão, among others). Anyway, a healthy lifestyle is very important in the treatment of reflux.

However, there are some cases in which the symptoms are more persistent and more difficult to control , even taking all necessary clinical measures. In such cases, there is the possibility of surgical intervention to better control the symptoms of reflux.

Surgical intervention is reserved for specific cases after undergoing an appropriate medical evaluation.

The main indications are:

  • Unsatisfactory improvement with clinical treatment.
  • Need for continuous use of medication to control symptoms, that is, the person cannot go without medication.
  • Young patients, especially those under 40 years of age, with symptoms that are more difficult to control and who will need to use medicine continuously for the rest of their lives.
  • When it is not possible to continue the clinical treatment for a long time, for example, due to the impossibility of paying for the long-term treatment financially or because of the side effects of the medications.

The main surgical technique for reflux is Nissen’s fundoplication . It is considered a safe and effective technique. Studies have shown that, after ten years, almost 90% of patients are still free of reflux symptoms.

Surgery can be done by videolaparoscopy . This procedure has proved to be excellent over the years, as it has improved postoperative pain, shorter hospital stay, faster return to daily activities and work, as well as more satisfactory aesthetic results.

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To better understand whether your case will benefit from reflux surgery (also known as Nissen surgery or hiatal hernia surgery), talk to an experienced surgeon. He must understand in detail how his illness was diagnosed, what has already been done for treatment and investigation, what and how much the symptoms bother you today and in the past, how is your health and what are your expectations. Generally, this conversation is accompanied by a detailed physical examination and technical analysis of a set of tests that detail how reflux happens in your specific case. This conversation with your doctor is essential to clear your doubts and decide the best treatment.

 

by Abdullah Sam
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