Gastroesophageal Reflux Disease (GERD)
Gastroesophageal Reflux Disease (GERD) is a common disorder in our society. While proton pump inhibitors (PPI) is the most effective acid suppression medication, only about 60% of patients show improvement of their symptoms. When a patient is diagnosed GERD and does not respond to PPI therapy, an Anti-reflux surgery should be considered. It is a minimally invasive surgery which helps the patients avoid the side effects of long term use of PPI. Please ask your doctor for details.
GERD is classified into three types:
- Non-Erosive Reflux Disease (NERD)
- Erosive Esophagitis (EE)
- Barrett's Esophagus
Although some scholars believe the above types of GERD are independent rather than a progression from one end of the spectrum to the other, most of the study have shown that untreated NERD can lead to EE.
Diagnosis
Ambulatory pH analysis and manometry
Normal esophageal pH is considered to be pH 5.0 to pH 7.0. The esophageal pH value of a severe GERD patient can be lower than 4.0. An ambulatory pH-monitoring device is usually used for continuous measurement of patients’ esophageal pH value for up to 96 hours. A patient is diagnosed of GERD if his esophageal pH value is always below 4.0 and related to symptoms.
Treatment
Surgical Cure for GERD
Acid reflux symptoms can be treated by surgical treatments. Patients received treatment generally enjoys improved quality of life.
Endoscopic Mucosal Resection (EMR)
Endoscopic Mucosal Resection (EMR) is performed through a gastroscopy to create an incision under the esophagus, resulting in the contraction of mucosa and esophagus. After the surgery, gastric acid can no longer move up to esophagus and therefore, the acid reflux symptoms like heartburn will disappear.
Laparoscopic Anti-Reflux Surgery (LARS)
Laparoscopic Anti-Reflux Surgery (LARS) is a minimally invasive surgery for correction of GERD by folding the fundus to the bottom of the esophagus. This would strengthen the function of low esophageal sphincter and effectively treat acid reflux. LARS has been proven by evidence to be a safe and cost-effective alternative to long term PPI. Patients received LARS generally enjoys improved quality of life.
