GERD occurs when the contents of the stomach and stomach acid move up into the esophagus — the tube that connects the throat to the stomach. A muscular area in the lower esophagus is meant to function as a 1 way valve, preventing the stomach contents from moving back up into the throat. The area where the esophagus passes through the diaphragm is normally only big enough for the esophagus tube itself, but in some cases the opening becomes larger. This allows the upper stomach to move up into the chest, called a hiatal hernia. If a hiatal hernia occurs at the same time that the esophagus valve is faulty, the acidic stomach contents can cause ulcers and heartburn. If this occurs over a long period, the esophagus may narrow, and cancer may develop. This group of problems is referred to as GERD.
Certain foods and drinks can contribute to GERD, including garlic, tomatoes, citrus, alcohol, and caffeine. GERD is also more common with people who are overweight or those who lay down after eating. Further, GERD also may be common with some medications or with pregnant women, although it typically passes once the baby is born.
GERD treatment typically starts with lifestyle changes, including improved eating habits and weight loss, if needed. If non-surgical changes aren't effective, surgery proves to be the best option for GERD. In a Nissen fundoplication, the surgeon creates 4-5 small incisions and inserts hollow tubes called trochars to perform the procedure.
This procedure is done using a laparoscopic approach, which causes less pain and allows for faster recovery. Most patients who have laparoscopic GERD surgery only need to stay in the hospital for a night and can return to their usual routine in around a week. Once the surgical correction has been made, patients resume normal eating but should always be cautious about highly acidic foods. Patients should also be careful to maintain a healthy weight.
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