5 signs it may be time for anti-reflux surgery

Acid reflux isn’t pleasant. Symptoms of acid reflux include heartburn (a painful burning sensation in your abdomen, chest, or throat), regurgitation (acid backing up into your throat or mouth), and dyspepsia (burping, nausea, bloating, and abdominal pain/discomfort). If acid reflux occurs frequently and chronically, you may be diagnosed with gastroesophageal reflux disease, or GERD, which is a chronic digestive disease.

What causes acid reflux and GERD? There is a muscle called the lower esophageal sphincter (LES) that acts as a valve between the esophagus and the stomach, allowing food to pass into the stomach and preventing stomach contents and acid from backing up into the esophagus. When the LES is not functioning properly, gastric juices “reflux” up into the esophagus, resulting in a host of unpleasant symptoms.

The first course of action in acid reflux treatment is typically lifestyle changes such as weight loss, dietary changes to avoid trigger foods, reduction in alcohol and caffeine intake, and changes in eating habits such as eating small meals and not eating right before bed. Also, over the counter antacids such as Tums may be used in moderation. If symptoms persist despite these changes, your doctor may prescribe an acid reducing medication such as a proton pump inhibitor (PPI) or histamine H2-receptor blockers. The final option is anti-reflux surgery.

So, you’ve been dealing with chronic acid reflux or GERD for a while…how do you know if it’s time to consider anti-reflux surgery?

One: Medication Ineffectiveness

You’re making lifestyle changes, you’re taking your PPI or your H2 blocker exactly as your doctor prescribed, but you’re still experiencing “breakthrough” symptoms. Anti-reflux medication is generally very effective, so if you’re still experiencing frequent symptoms despite the pill you’re popping, it’s time to consider surgery.

Two: Medication Side Effects

Maybe your medication is working great…except for all those pesky side effects it’s giving you! Side effects from PPIs and H2 blockers are rare, but you may be one of the few unlucky people who experiences headaches, diarrhea, constipation, nausea, or itching, in which case the prospect of continuing to take that medication long-term may be unappealing.

Three: Esophageal Problems

Untreated acid reflux can lead to some serious complications. If you are developing severe problems in your esophagus due to reflux or GERD such as scarring, narrowing, ulcers, or bleeding, it may be time to take a more serious approach and consider surgical intervention.

Four: Barrett’s Esophagus

Barrett’s esophagus is a complication that can result from GERD, and it happens when the normal tissue lining the esophagus changes to tissue resembling the lining of the intestine, increasing your risk of developing esophageal cancer. This is a serious problem, and if you develop Barrett’s esophagus this is a sign you need to get your reflux under control ASAP.

Five: Personal Preference

Some people have a hard time maintaining a medication regimen or fear the long-term side effects of using PPIs or other medications used to treat reflux. Also, many people just don’t want to take lifelong medication, for a variety of personal reasons. Whatever your reason, if long-term medication for managing your acid reflux or GERD isn’t an option, anti-reflux surgery may be for you.

If you do decide to go the surgical route, keep in mind that anti-reflux surgery has risks as well as benefits, and it is important to discuss these with your doctor. There is testing that is required prior to surgery to determine if you are a good candidate, as well as a hospital stay post-procedure and dietary restrictions lasting as long as two months. (A liquid diet isn’t for everyone!)

However, anti-reflux surgery is generally very successful and most patients report an improved quality of life. So if you are experiencing any of the above signs that it may be time for anti-reflux surgery, weigh the pros and cons, do your research, and, most importantly, talk to your doctor. Your esophagus will thank you! 

By Margaret Durkovic

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