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Heartburn is a major cause of morbidity, causing recurrent discomfort, days missed from work and financial loss. Certain substances or foods, such as citrus products, chocolate, fatty foods, caffeine, tobacco, alcohol or tomato products all cause GERD due to their ability to weaken the Lower Esophageal Sphincter (LES).
The LES is a ring of muscle that separates the stomach from the esophagus. After you eat, normal, coordinated contractions in the esophagus deliver food to the stomach. When food arrives, the LES contracts and acid is secreted into the stomach. If the LES is weakened acid can rise into the esophagus and cause irritation and burning. If acid is able to rise high enough into the esophagus, it may lead to a chronic sore throat, hoarseness, cough or wheezing. Some people take anti-acid medications (e.g. Omeprazole) that may limit or prevent damage to the esophagus and control other symptoms.
Some people have such severe LES weakness that medications, weight loss and dietary discretion do not effectively control GERD. Surgery may be an option. Common antireflux surgical procedures include the Nissen Fundoplication, the Laparoscopic Nissen Fundoplication, the Belsy Mark IV and the Hill Gastropexy.
The indications for surgical correction or modification of faulty LES function or other anatomical considerations that may lead to GERD include:
- Persistent or recurrent symptoms despite medical and non-medical interventions
- Esophageal stricture (scarring of the esophagus causing constriction)
- Barrett’s Esophagus (potentially pre-cancerous changes in the lining of the esophagus)
- Severe esophagitis as determined by endoscopy
- Recurrent pulmonary problems caused by GERD such as aspiration pneumonia or asthma
If you and your doctor have decided that surgery is an option, and you do not have the means to pay for surgery at this time, consider a highly qualified surgeon in Mexico. MedToGo works with experienced surgeons that can perform your anti-reflux surgery at a fraction of the cost.
Before you go for surgery, make sure that the decision is the right one. You should have an Esophageal Manography study to determine the muscular function and the pressures within the esophagus. Manography is essential to exclude muscular diseases such as Scheroderma or Achalasia as the reason for your GERD, as these conditions are not treatable with surgery. Also, Manography can tell you a lot about the function of the LES. If you have low LES pressures (poor sphincter strength), you will likely do well with antireflux surgery, which works to tighten up LES muscle tone. We also recommend that you have an upper GI. An upper GI will provide important anatomical information about your esophagus and stomach that will help the surgeon decide what type of operation is right for you.
Once you have completed these studies, meet with a gastroenterologist or general surgeon in your area to discuss your options. Ultimately the decision to go to surgery will have to be between you and your doctor(s). The Manography and the upper GI studies will help your team determine what type of antireflux procedure is best for you. When you have made your decision, MedToGo can help you find an experienced surgeon and help you keep a lot of your hard earned money. When it comes to antireflux surgery, experience is an extremely important determinant of outcome.