FACT SHEET TOPIC: Gastrointestinal Procedures

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What is GERD?
Gastroesophageal reflux (GERD) is caused by stomach acid spilling up into the esophagus. This occurs if the valve at the bottom of the esophagus (top of the stomach) opens at the wrong time or simply fails to close. A burning pain, commonly called heartburn, often, but not always accompanies GERD. Left untreated, GERD can become a debilitating problem, resulting in scarring, swallowing difficulty and even cancer.

What is a hiatal hernia?
The junction between the esophagus and the stomach passes through the diaphragm. This opening in the diaphragm is referred to as the esophageal hiatus. When the attachments between the diaphragm and esophagus become weak, the stomach can slide up into the chest, causing a hiatal hernia. While some people may experience no symptoms, in others, a hiatal hernia can contribute to GERD.

How serious can it be?
Bleeding ulcers in the esophagus and a narrowing of the esophagus due to scarring are two of the more serious problems caused by chronic reflux. The result may be difficulty swallowing solid foods. Medical treatment for GERD includes avoidance of foods and drugs that relax the lower esophageal muscles and the administration of acid-reducing medications.

Is surgery indicated?
Since GERD is a mechanical problem, the methods listed above can at best only minimize the symptoms. Patients who continue to have symptoms despite medications, have extensive scarring, or who have cell changes suspicious for malignancy are candidates for surgery to repair the lower esophageal sphincter valve, thereby preventing the spill of acid up into the esophagus. If the patient's condition allows, the surgeons of North Valley Surgical Associates recommend utilizing a minimally invasive surgical technique, wherein the operation is done through small incisions under the guidance of a tiny telescope and video camera.

What are the advantages of minimally invasive surgery?
Since minimally invasive procedures do not require large incisions, patients generally experience less pain. Hospital stays are shortened to only a day or two. And, most patients are able to return to regular activities in one week.