Acid reflux – otherwise known as gastro-oesophageal reflux (GORD) is a condition where the natural defences within the body’s upper digestive system is impaired. These defences are in place to prevent the acidic contents of the stomach entering the oesophagus causing a burning sensation that in laymen’s terms we call heartburn.
One of the primary causes of this condition is a hiatal hernia – a condition where the stomach protrudes through the diaphragm into the chest cavity. The other is damage of the anti-reflux defense mechanisms including lower oesophageal sphincter (LOS).
Approximately one in five people in the developed western world suffer from GORD and require acid reflux treatment. Prolonged reflux can lead to damage to the lining of the oesophagus causing various complications such as oesophagitis, ulcers and Barrett’s oesophagus.
Diagnosis is usually confirmed by tests like gastroscopy, barium swallow x-ray and oesophageal pH and manometry test.
Surgical therapy should be considered, when a diagnosis of reflux, acid or non-acid (or bile reflux), is objectively confirmed and when the patients:
- Have failed medical management (inadequate symptom control, severe regurgitation not controlled with acid suppression)
- Some patients opt for a surgery, despite successful medical management to avoid taking medication or if they develop side effects to the medication
- Due to complications of GORD, including erosive esophagitis, stricture, and/or Barrett’s oesophagus (condition where the inner lining of the oesophagus changes to that of the stomach lining, due to acid irritation)
- Have extra-oesophageal manifestations, such as asthma, hoarseness, cough, chest pain, and/or aspiration