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FOREGUT SURGERY:

Gastroesophageal Reflux Disease (GERD)

Common Symptoms: heartburn, regurgitation, & dysphagia

Approximately 10 to 20 percent of people in the United States have the most common symptoms of gastroesophageal reflux disease (GERD): heartburn, regurgitation, and dysphagia. (Less common symptoms include bronchospasm, laryngitis, chronic cough, chest pain, and others.)

Symptoms are considered clinically significant if they occur in a mild form two or more days per week, or in a moderate to severe form more than one day per week.

A presumptive diagnosis of GERD can be made based on clinical presentation; however and before surgical or endoscopic treatments testing with upper endoscopy, esophageal manometry or 24h ambulatory pH monitoring is usually necessary. These tests will look for commonly associated esophageal mucosal damage such as esophagitis, ulcers, strictures, Barrett’s esophagus, hiatal hernias; study the status of the lower esophageal sphincter (LES) and esophageal body and provide objective documentation of abnormal reflux of gastric contents into the esophagus.

Medical definition of GERD:

“Symptoms of Esophageal Mucosal damage that is produced by abnormal reflux of gastric contents into the esophagus” 1

Medical Management & When to Consider Surgery

For patients with mild GERD, symptoms may improve by losing weight, changing diet, and/or taking antacids, H2 blockers, or proton pump inhibitors. However, surgical treatment may be recommended when:

  • Medication doesn’t completely relieve symptoms that are known to be caused by reflux;
  • A patient does not want or cannot take medications long-term due to presence or fear of short term and possible long–term side effects; or
  • In addition to reflux, a patient has asthma, hoarseness, or cough that does not improve with medication.
  • It is also an option for those who do not wish to stay on medications permanently in order to control their symptoms.

Minimally Invasive Endoscopic & Surgical Options

The type of therapy chosen is tailored to individual patient characteristics such as age, presence of a hiatal hernia, how well the esophagus works and others.

The minimally invasive endoscopic and surgical treatment options for patients with well-established GERD are:

Share Your Insights

Do you have additional knowledge, experience, or questions on this topic? We’d love to hear from you—please send us a message with your feedback!

For More Information

For more information about the diagnosis and treatment of GERD contact our surgery team at (804)827-0045 or email us at:

reflux@vcuhealth.org


DeVault KR, Castell DO, American College of G. Updated guidelines for the diagnosis and treatment of gastroesophageal reflux disease. Am J Gastroenterol 2005;100:190-200.

FOREGUT SURGERY

GERD (Gastro-Esophageal Reflux Disease)
Lap Anti-reflux Surgery
LINX® Reflux Management
Endoscopic Stretta Therapy®

Esophageal Achalasia
• Lap Heller Myotomy
• Endoscopic Balloon Dilation
• Per-Oral Endoscopic Myotomy

Para-Esophageal Hernias
• Laparoscopic Repair

Gastroparesis
• Enterra® Therapy
• Lap Surgical Options

Esophageal & Gastric Cancer
• Minimally Invasive Treatments

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  last updated: 06/17/2016