General Surgery

Reflux Surgery

Gastro-eoesophageal Reflux Disease (GORD) is a condition where stomach contents (food, liquid or acid) reflux back into the oesophagus (gullet) from the stomach.

What are the causes of reflux?

Everybody experiences reflux at some point in their life but serious reflux usually occurs when there is a weakening of a valve (lower oesophageal sphincter) between the gullet and the stomach. This defect causes a hiatus hernia resulting in the overproduction of acid in the gullet. Other causes of GORD include:

  • Smoking
  • Alcohol use
  • Overweight
  • Pregnancy

What are the symptoms?

People complain of heartburn, which is a painful burning sensation in the chest. People may experience sudden regurgitation of food in the back of the throat, especially when bending over or lying down at night.

How is reflux investigated?

Reflux is diagnosed by a gastroscopy which allows endoscopic visualization of the oesophagus (gullet), stomach and duodenum looking for a hiatal hernia and inflammation of the lower oesophagus. Other tests include pH monitoring of acid in the oesophagus and manometry which determines whether the oesophagus is contracting and relaxing properly

What is the treatment for reflux?

Lifestyle modification can play role and there several measures patients can take to reduce reflux:

  • Lose weight if you are overweight
  • Elevate the head of the bed at night
  • Avoid smoking and use of alcohol
  • Avoid eating before going to bed
  • Eat smaller and more frequent meals
  • Taking antacid medication

What are the indications for surgery?

  • GORD and a large hiatus hernia
  • People who suffer complications from their reflux eg. aspiration
  • People who are have severe symptoms despite medications
  • People who do not wish to take life-long anti-reflux medication

Surgery for Reflux

The operation for reflux is called a Laparoscopic (keyhole) Fundoplication. This is a minimally invasive operation where 4 small incisions are made in the upper abdomen. The procedure involves partially ‘wrapping’ the upper stomach in front of the oesophagus (gullet) to reinforce the strength of the lower oesophageal sphincter muscle. The majority of patients go home the next day. Dr Ghosh will discuss your condition in depth and the surgical and non-surgical options which are available.