Gastro oesophageal reflux disease also commonly known as reflux disease is associated in young adults to old age. It’s can be constantly debilitating disease as symptoms persists whole day and they can increase as the day progresses and when patients lie down. Medical management has very successfully able to control the symptoms but this could be of temporary relief
Common risk factors with reflux disease
- Old age
- Consumption of high fatty diet
- Consumption of alcohol, and caffeinated beverages
- Spicy food and mint containing candies
Common symptoms of reflux disease
- persistent heartburn
- Regurgitation of liquids and food
- Atypical chest pain
- Sore throat
- Pain upper abdomain due to associated ulcers
- Pschyological anxiety and fear associated with reflux
- Weight loss with chronic reflux disease
Diagnosis and investigations
These symptoms develop over the course of time as the severity increases grade of reflux. However, initially consultations, clinician usually prescribe with over the counter available routine medications which ameliorate the symptoms very effectively. With persistence of symptoms, it is essential to undergo upper gastrointestinal ( UGI) endoscopy) to examine the degree of reflux ( associated hiatal hernia) , size of hiatal hernia , gastric ulcers and take biopsies for H. Pylori examination. Contrast enhanced computerised tomography (CECT abdomain) are evaluation of large hiatal hernias
Treatment of gastro oesophageal reflux disease
Medications and lifestyle modifications ( control over risk factors as mentioned above) remain the first line treatment for the reflux disease. However, persistent symptoms controlled for medications with years, large hiatal hernia ,obesity induced hiatal hernia are preferably managed by surgeons.
Minimal access surgery ( laparoscopic surgery ) has become the gold standard for management of reflux disease associated with hiatal hernia. The surgery is know as fundoplication which are subdivided in to various types depending upon the degree of wrap of stomach created around oesophagus during surgery.
Obesity related hiatal hernia surgery involves bariatric surgery and the gold standard remains laparoscopic RouX-en-Y bypass surgery which helps in weight loss and at the same time reflux problem of the patient is also taken care.
Recovery after surgery
The recovery after surgery is very rapid and patients are usually discharged with in 1- 2 days. The patients usually can return to work with couple of days and patient is advised to follow gradual diet from liquid to solids. Patient usually feel immense relief after surgery.
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