Gastro-oesophageal reflux (heartburn) is due to the refluxing of gastric acid from the stomach into the oesophagus. This causes a chemical burning of the oesophagus and subsequently pain. It is common (up to 20%) but typically occurs infrequently and is controlled with antacids. However, if symptoms persist >2 days/week then medication to reduce acid production is required. If the reflux is not controlled with the acid suppressing medication or damage to the oesophagus has occurred (oesophagitis) then anti-reflux surgery may indicated.
Gastric reflux occurs due to a failure of the lower oesophageal sphincter (muscle) mechanism comprised of the diaphragm, oesophageal muscle and intra-abdominal attachments. Reflux can be worsened by a hiatus hernia (movement of the stomach through the diaphragm in to the chest) due to widening of the diaphragmatic defect through which the oesophagus passes into the abdomen.
Risk factors for developing gastric reflux are
- Hiatus Hernia
- Caffeine intake
- Obesity
- Connective tissue diseases
Surgical treatment comprises of a laparoscopic (keyhole) operation to reduce the stomach into the abdomen, close any diaphragm defect and partially wrap part of the upper stomach over the oesophagus to reinforce the oesophageal sphincter mechanism.
If you wish to discuss further please book an appointment with Dr Rothwell.