GERD stands for gastro esophageal reflux disease. It is caused as result of reflux of acid produced in the stomach into the food pipe through a defective valve.
The patient complaints of bloating, heartburn, sour taste in mouth, nausea and cough. Sometimes, liquid or even solid food can come to the mouth because of reflux. The symptoms occur after heavy meals or spicy/oily food. They can occur at night when patient is sleeping.
The diagnosis is suspected by the clinical history and confirmed by doing an upper GI endoscopy. This would show the presence of a lax sphincter at the GE junction with or without hiatal hernia.
Initially, patients are started on medical treatment with drugs which lower acid production and decrease reflux. They are also advised to modify their lifestyle and eating behavior to minimize symptoms.
Patients who have severe, chronic reflux symptoms, lifestyle impairment, not responding to medical treatment or complications like ulcers or difficulty in swallowing food may require surgery.
The operation for GERD is fundoplication. It is almost always performed laparoscopically. It consists of wrapping the upper portion of stomach around the lower esophagus to create a new valve which prevents reflux.
The operation takes around 90-120 minutes to perform and the length of stay is around 3-4 days.
The patient is kept nil per oral for 24 hours after the operation. Initially, clear liquids are started and they can take soft diet subsequently which is continued for 2 weeks following the surgery.