The Benefits of Reflux Surgery

Anyone who suffers from heartburn will tell you how uncomfortable it is to enjoy simple pleasures like eating and drinking.

Although there is an abundance of tablets and liquids available both over the counter and on prescription, they aren’t always 100 percent reliable.

Reflux is often dismissed as something that can simply treated with a short-term cure, but severe heartburn could also be a symptom of Gastroesophageal reflux disease (GORD) and may be better treated treated with anti-reflux surgery.

What is GORD? 

GORD is a digestive disorder that occurs from a weak or dysfunctional lower esophageal sphincter (LES).

The LES acts likes a barrier between the oesophagus and stomach. The LES opens up to allow food or drink to pass through into the stomach, but then closes to stop the contents and stomach acid to flow back into the esophagus. But when your LES is weakened or dysfunctional, acid may flow back into the esophagus, which can irritate and cause inflammation resulting in heartburn. While many patients with reflux disease can control their symptoms with over the counter or prescribed medications and lifestyle changes, there are some patients that will do better with surgical treatment.

The patients who usually consider surgery are patients with:

1. Persisting regurgitation of fluid/reflux, especially if it occurs at night preventing them from sleeping well.
2. Persistent heartburn despite appropriate medical therapy.
3. Cough, asthma or shortness of breath.
4. Persisting oesophageal ulcers
5. Complicated Barrett’s (Barrett’s oesophagus is a potentially pre-cancerous condition associated with longstanding reflux).
6. Patients intolerant to medications or those who want to avoid a lifetime of medications.
7. Patients with swallowing problems (called dysphagia).

What happens during the surgery? 

Patients undergo a laparoscopic or keyhole procedure called fundoplication. This is where the surgeon wraps the top part of the stomach around the end of the esophagus to reinforce the LES recreating the barrier that protects the esophagus against acid reflux.

A fundoplication is a laparoscopic operation that takes about 40 minutes. Patients spend 1-2 nights in hospital and have a modified diet for 4 weeks before going onto normal food. 95% of patients leave hospital off their anti-acid medications and the majority can stay off their anti-acids for at least 5-10 years.

There are new anti-reflux treatments available as well, such as an endoscopic treatment called Stretta. This is an outpatient, non-surgical treatment that is able to help patients get off medications without surgery.

How can reflux surgery help? 

The results from anti-reflux surgery in both short and long-term patients have been effective in symptom reduction and an overall improved quality of life. Most patients are taken off their reflux medication post surgery. Imagine finally being able to enjoy a meal out without carrying the anti-reflux medication or being woken up at night with reflux.

Determining whether you need to undergo such a procedure starts with a simple test at a specialist; they will be able to diagnose and recommend appropriate treatment based on the severity of your symptoms. While these tests are simple they are only available at a limited number of places in NSW. We offer oesophageal function testing at Kogarah and Orange, and have NSW’s longest running modern or “Hi-definition” lab.

If you’re concerned about heartburn or have other reflux-related issues, a referral from your GP is all it takes to start the process of exploring the options for treatment of your reflux symptoms.