What causes reflux?
Reflux is caused by some of the stomach acid surging up the Oesophagus. When working properly, there is an area of high pressure in the lower oesophagus just above the junction with the stomach (lower oesophageal sphincter) which lets swallowed food and liquid pass through to the stomach but prevents acid and stomach contents from refluxing back up the oesophagus.
How is reflux diagnosed?
Reflux disease which is ongoing and causes distress is called gastro-oesophageal reflux disease or GORD. A Gastroscopy is used to diagnose reflux and rule out symptoms from other causes. This involves a day procedure with a thin fibre optic device (a camera) being swallowed while sedated and photos or biopsies are taken. Other investigations include a gastro-graffin swallow which helps to assess the oesophageal function and objectively define reflux and a CT scan that helps to define the anatomy of the stomach, diaphragm, and oesophagus. Other tests that are occasionally required include pH Manometry studies.
What is a Hiatus Hernia?
A Gastroscopy or CT scan will show if a Hiatus Hernia is present. This is when part of the stomach (or other organs of the abdomen) protrudes into the chest through the hiatus. It is very common for people to have significant reflux symptoms with a hiatus hernia. This is repaired at the time of surgery usually using sutures but occasionally a mesh may also need to be placed.
Is surgery an option for reflux?
Surgery can be an option for people who suffer from persistent reflux which can’t be managed with medication or change in eating and drinking habits. It is common and affects 1 in 5 adults and is more common in those over 40 (RACS 2019). The symptoms people experience can include a burning feeling in the throat, acidic tastes in the mouth, difficulty swallowing, chest pain, wheezing and coughing.
How does surgery help?
In your consultation, Dr Wylie will discuss how surgery would strengthen the “valve” of the Oesophagus using a technique called Fundoplication. This wraps the top of the stomach (the fundus) around the bottom of the Oesophagus to provide support so the stomach contents are less likely to reflux. Surgery is usually performed laparoscopically, commonly known as keyhole surgery.
What can I eat after surgery?
For the first few weeks after surgery you will be on a modified diet, starting with liquids and progressing to soft foods while you recover. Dr Wylie works with a team of dietitians experienced in reflux surgery management who can provide you with personalised nutritional advice as you need it, preparing for surgery and in the weeks afterwards.
What if I am obese and have reflux symptoms?
Obesity is strongly associated with reflux and often significant weight loss will relieve these reflux symptoms. Certain weight loss procedures can help both to eliminate reflux and reduce weight. The decision whether to perform reflux surgery or weight loss surgery that will also manage reflux is determined on an individual basis.
Can we talk about the risks with surgery?
Surgery is not without risk and in your consult with Dr Wylie, you will together discuss the risks as they relate to your personal health profile.