Investigations done for Acidity –
Endoscopy
24 hour pH study
Manometry
CT Scan /Barium Study
Treatment –
Lifestyle modification ,food alteration ,stopping smoking ,weight reduction, proton pump inhibitors and anti H.pylori treatment are intergral part of Medical treatment of GERD. Surgery has its own definite indications.
Surgical Management-
Laparoscopic Surgery has revolutionized Surgery for GERD or acidity. Surgery known as Fundoplication and its variants Laparoscopic Nissens Fundoplication ,Toupets Fundoplcation and Dorr Fundoplication is done for acidity.
When is Surgery advised for Acidity-
Relapse or recurrence in patients medicines/incomplete resolution after medicines.
Young patients who may require lifelong PPI’s due to persistent symptoms.
Long duration of symptoms.
Large hiatus hernia.
Complications of medicines-Calcium deficiency and Osteoporosis,anemia ,bacterial overgrowth etc.
Barretts esophagus ,Ulceration ,Stricture or recurrent aspirations.
Surgical Procedures –
Laparoscopic Nissens Fundoplication is the most popular Anti reflux Surgery. It is a 360 wrap of fundus of stomach above the GE Junction . Surgery aims at bringing the GE Junction into the abdomen which may have migrated into the thorax due to shortening as a result of chronic reflux or due to laxity of hiatus .The GE junction is augmented by this wrap which prevents reflux into esophagus.
Obese patients with body mass index above 32.5 require Laparoscopic Gastric bypass (RYGB) instead of Fundoplication. Bariatric Surgery resolves both the issues, GERD and Obesity at a time.
Long Term results –are good with 90% of patients completely free of medications and symptoms .Some patients may experience short term bloating post surgery which settles with dietary modification.
Dr Kedar Patil at Presize Clinic Pune is a acidity specialist and provides acidity treatment in form of endoscopy and Laparoscopic Surgery for Acidity.
