 GERD on the rise
"Laparoscopic anti-reflux surgery has been gaining in popularity for the treatment of severe symptomatic gastro esophageal reflux disease," says Dr
Ravindran Kumeran, leading surgical gastroentrologist, Apollo Hospitals, and managing director, Admert Medical
Centre.
Laparoscopic anti-reflux surgery is increasingly being used for the treatment of severe symptomatic gastro esophageal reflux disease (GERD). The
most important causes for GERD are changing lifestyle, stress, long hours of starvation, eating oily food, smoking and excess alcohol intake. This
causes heartburn or cramping pain behind the chest and regurgitation.
GERD is a common problem in the modern world. It involves the junction between stomach and the oesophagus. The oesophagus (food pipe) is a
tube-like structure, about 25 cm long, lying in the chest. Two cm of this tube lies below the diaphragm. The main function of the oesophagus is to
transfer food from the mouth to the stomach both by voluntary and involuntary movements. For more details one can contact Admert Medical
Centre, 9/4, Railway Colony First Street, near Sony World, off Nelson Manickam Road, Chennai – 600029. Tel: 4355 3000 / 098410 07181.
Dr Ravindran Kumeran said, "If long-term medications fail to control symptoms, laparoscopic fundoplication could be the best alternative. This is done
under general anaesthesia and is relatively painless. Using a trocar (narrow tube-like
instrument), the surgeon gains access to the abdomen through the navel. A laparoscope (a tiny telescope) connected to a camera is inserted through the trocar allowing the surgeon a magnified view of the
patient's internal organs on a monitor. This procedure is safe because there is only minimal tissue damage and blood loss. So there is no need for long
painful ugly scars and blood transfusions. Since the opening is small, there is faster healing. Patient returns to normal health rapidly."
Dr Ravindran further said, "Medication helps to suppress acids secretion and improves symptoms temporarily, but relief cannot be guaranteed over a
longer time period. Patients with symptoms not adequately relieved in spite of medication (or) developing severe complications like ulceration and
bleeding, need to undergo surgery. In patients with repeated sore throat and worsening of wheezing or asthma due to GERD, it is advisable for the
patient to undergo anti-reflux surgery."
Gastro esophageal reflux is a common condition and frequent cause for doctor consultation. The foodpipe-stomach junction in the human body is
designed to prevent the stomach contents from refluxing upwards - it functions as one-way valve. When this junction is abnormally relaxed, stomach
contents including acids, flow into the oesophagus ('two-way traffic'). This leads to 'heartburn'. Heartburn is a burning sensation which a GERD
patient can perceive in the lower chest (oesophagus). It happens when the acid reflux from stomach gets in contact with the food pipe which it
cannot withstand. If this process continues for a longer period of time, the inner lining of the food pipe becomes inflammed and can lead to
oesophagitis, ulceration and bleeding.
Symptoms
Pain or burning sensation in the upper abdomen & lower chest, sometimes radiating to the back (heartburn).
Stomach contents reflux on bending over which is very common after full meal.
It typically occurs after a large oily meal associated with drinking alcohol & smoking.
The following changes in lifestyle can reduce the risk of developing reflux:
a) Weight reduction
b) Avoid large, high-fat meals.
c) Stop smoking
d) Reduced alcohol consumption.
e) Avoid going to bed immediately after having food
f) Lying down with head end of bed in an elevated position
g) Avoid fizzy (carbonated) drinks.
Dr Ravindran Kumeran added, "Some GERD patients are at a higher risk of food pipe cancer. The drug expenditure cost of for these patients runs into
several billions worldwide. To prevent treatment cost from exploding, Laparoscopic Anti-Reflux Surgery (key-hole surgery) is the best option. This
disease is commonly found amongst patients in the age group from 20-40 years. In India, as a developing nation, the changing food consumption
patterns and lifestyle has increased the number of GERD patients. It is an unpleasant condition and can have a big influence on your lifestyle."
R Rangaraj
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