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Gastro Esophageal Reflux Disease “Pills for life or Surgery”

32 years young executive working at an MNC, troubled with acid reflux causing chest pain for the last 5 years, undergone multiple upper GI endoscopies and frequent Gastro OPD consults, being prescribed almost all type of antacid medications available in the market, almost at the verge of quitting her job” is what I gathered when she consulted me.

Clinical Walkthrough

Upon reviewing her thick medical file, she had refractory gastroesophageal reflux disease (GERD) which is reflux of stomach contents rich in acid and bile back to the esophagus leading to myriads of symptoms where weak lower esophagus muscles are largely responsible.

Acid reducing medications does minimise the symptoms but can’t augment the weak muscles hence “it is no guarantee against ongoing acid reflux” and subsequent ongoing damage of lower esophagus may predispose her to develop cancer in long run which is almost fatal. Medical therapywill be needed forrest of her life with its attributable side effects and cost.

Options of “Pills for life” or “surgical correction”which is safe, durable and would possibly make her “Pills free” and might restore her normal life style discussed with the patient.

Surgery for reflux disease“Fundoplication” is performed bylaparoscopy or robotic. The upper part of the stomach is used to create awrap around the lower 3 cm of esophagus creating a “Neo-sphincter”. The procedure usually takes 45 minutes, patient needs to stay in hospital for 2 days, returns to works within a week. The results are immediate with success of 95% in controlling symptoms in long term. Need for Pills reduces to less than 5% and even if needed, it is SOS. More importantly surgical “Neo-sphincter” possibly prevent long term acid and bile reflux to “guarantee against development of cancer”.

The patient considered the surgical options for better, she is “Pills free”, back to her high-profile job with no intentions to quit it”.

Categories: Laparoscopic Fundoplication

Tags: GERD, reflux disease, laparoscopic fundoplication, robotic fundoplication