DRLUGO BLOG

This is commonly known as reflux.  As the word suggests, there is reflux or regurgitation (comes up the throat) of stomach contents.  These stomach content is mostly acid, but at times, in severe cases can be food.  The symptoms can be as vague as bloating, but can involve burning in the upper abdominal area, pain, difficulty swallowing or a chronic cough.  Most people that have it treat it with over the counter remedies.  Although the symptoms usually respond to simple antiacid medication, we should not ignore these symptoms.  The mere fact that a person has reflux symptoms is an indication that something is not working well.  It may be caused by eating late late eating,  being overweight or a problem with the sphincter (circular muscle) that separates the eophagus from the stomach.  Reflux can also be the result of other diseases like scleroderma or even viral conditions.  Although common and easily treated many times, we should not ignore the symptoms and seek help.  A patient should not just treat the symptom and forget looking for the cause.  Just treating the symptoms can be dangerous and bad for the person.  Chronic reflux, if uncontrolled, could lead to cancer of the esophagus and or ulceration.  This is a big problem now a days since many of the reflux medications are available over the counter for the patient to treat themselves.  This allows for a person to treat a symptoms for a long time and not treat the cause.  IT is my opinion that this can lead to more serious problems.

 Although there are no real medical standards defined, on the frequency of endosopy to follow patients with reflux, I think it is appropriate to get this test done at some time to determine if there has been any damage made to the linning of the esophagus and then treat it accordingly.  

From the surgical stand point there is an operation called Nissen fundoplication.  This consists of wrapping the stomach around the lower part of the esophagus t try to restore the some of the physiology that is lost when the lower esophageal sphincter is not working.  Now a days it is done laparoscopically and has very good results when done well.  We reserve this for patients that get no relief with the medications known as PPI (proton pump inhibitors).  these are medications that we have been using for years now and usually are enough to stop the symptoms caused by GERD.  sometimes the pt has a large associated hiatal hernia. In these cases surgery is probably going to be necessary to improve the symptoms.  Not all hiatal hernias need to be operated on and this is a decision that the doctor can make with the patient.  Please visit my website for questions www. DRLUGO.com