Symptoms and Treatment Options for GERD, Part 3

Welcome back to today's health Today, we're talking about GERD with surgeon dr

Zubin Bhesania Doctor, to recap for our viewers What again are the symptoms of GERD? So what's in patients will typically complain of heartburn and? It's like a burning sensation They'll feel at the top of their abdomen or lower chest occasionally they'll complain of Reflux of liquid they'll have a taste of acid or bile in their mouth And it can happen when they're sleeping it can happen when they bend over to tie their shoes happen when they're straining Sometimes people have nausea People also complain of coughing so they're at night They're coughing They lay down and almost and they start coughing and that's because their reflux in liquid that irritates the back of their throat sometimes people are complaining of Trouble breathing they'll have a worsening of asthma or new onset asthma And that occurs because people are refluxing while they're asleep And they are actually aspirating a small amount of that liquid which burns the inside of their Airway, and it creates a reactive airway Some of the most common complaints that we see with GERD Now there are a couple of non-surgical treatment options available Can you provide an overview of those again so typically when patients will complain? To their family doctors about heartburn or reflux or indigestion? The most common treatment is at medical therapy, and we have millions of people out there that are on medications for reflux They fall in two classes of drugs on the the h2 blockers And one is the proton pump inhibitors and they both work well the proton pump inhibitors typically work a little better and Depending on a patient's drug insurance the doctor will prescribe them one of these drugs to help with GERD now by taking some of these medications Well it actually cure the GERD or does it just help with the symptoms So it doesn't cure it so what happens you take the medication it decreases acid production So when you do reflux it doesn't burn as much and that's how these products work so unfortunately It's not my a pill you take for a few weeks And the dirts God as soon as you stop the medication The GERD will return, so these are chronic conditions that are people that are people are taking these medications for And what's happened over time is we've realized that The medications and some people don't work well or the medications will create some side effect They'll create a different complication, and that's why there's been sort of a new Interest in surgical repair of GERD now What are some of the potential complications if GERD goes untreated? so if you can think the GERD is an issue where acid is coming up into the bottom of the esophagus the esophagus is not designed to handle acid and so it burns the esophagus it can create scarring of the esophagus and Create dysphasia where you eat and food feels like it's getting stuck It can actually damage the lining of the esophagus and that will create a problem down the road that over time The chronic attack of the acid on the bottom of the esophagus will lead to a change called Barrett's esophagus Which then can change the cell type of the esophagus and lead to esophageal cancer? Can the chronic presence of the acid cause bleeding in the esophagus? absolutely

so very Infrequently, I will see people that are diagnosed with anemia and what's happening is their esophagus is scarred and damaged from reflux and Over time their bleeding a small amount each day from that area which leads to anemia Now at what point do you recommend surgery for GERD? well typically patients have been on medication for a significant period of time before they get referred to me and the people that I see in my own practice for reflux are people that Either don't want to take the medications due to potential side effects or the medications aren't working well, or they're still having reflux Now doctor what surgical treatments are available for GERD so typically The problem with reflux is fixed laparoscopically with so it's a minimally invasive procedure to repair the lower esophageal sphincter 20-30 years ago we had to do an open technique which is a big incision that was basically from your Breastbone to your bellybutton in order to repair this because it's up high and your chest so it's very difficult to get to And create a lot of complications just from the surgery, but with the advent of the laparoscope we were able to fix this problem relatively easier with very small incisions So people do well so to use the minimum vasive approach we can repair the hollow hernia fix the acid reflux issue in a very short operation so 3540 minutes to fix the problem and then people do better because they're up walking that day They get home the next day, and they're on a slightly modified diet for healing Basically, they're on soft foods for about two weeks, and then they can start eating regular food But they can get back to work quickly so if you're at a desk job You can return to work And you know three to seven days if you have heavy lifting in your job you're off for a couple weeks But people don't have a significant amount of pain with the procedure and they get back to normal recovery Pretty quick treatment has come a long way with the invention and the robot and minimally invasive procedures yep So what is the name of the procedure that you use to correct so the the most common procedure is the Nissen fundoplication? And it was created by dr Newsome back of 50s so in this procedure what we're doing is finding the high-low hernia bringing the contents of the hernia back down within the abdominal cavity and then closing the hole in the diaphragm and the Muscles of the diaphragm are called the crews we actually closed the crews around the esophagus So part of the key treatment of reflux and why reflux happens is with a hiatal hernia the Esophagus goes up into the chest slightly it needs to be within the abdominal cavity and so we by bringing it back down to its Normal position we sort of recreate normal and anatomy and improve lower esophageal sphincter Function now there's another procedure using a links device Can you tell us more about that yeah, so this is a newer procedure and it's done laparoscopically And what the links device is is a series of? Magnetic beads so we have this almost like a pearl necklace type of beads that are placed around the lower esophageal sphincter and What they do is help close it? So what happens is when you're not eating the magnets sort of stick together and create pressure on the lower esophageal sphincter And then when you do eat they don't have enough strength the food gets pushed through But then it closes back and so it's an operations done laparoscopically in order to improve lower esophageal sphincter Function now what does recovery look like for both of these procedures the recovery is pretty similar Once again these are minimum asa procedures They're very small incisions You know five to ten millimeter incisions and People recover really quickly it's almost an outpatient procedure wow that's great How long do you know how long does it take before you know if the procedures are successful? Typically people will have no more reflux right away They'll know right away, and we actually stopped the acid medications right away So once you have this procedure done

You should never have GERD again correct I mean the GERD should be dramatically improved People may still have some if they overindulge and they have a big meal an occasion can happen, but it should be significantly improved Dr This has been great information today Thank you for joining us and Thank you for watching if you have questions need a physician referral or have suggestions for topics You'd like to hear more about you can contact us by calling health access at 1-800 two two eight one four eight four you can also watch today's health request a copy of our program and access other reliable healthcare information by visiting our website as Always tune in next time to today's health Today's health is brought to you by McLaren, Port Huron

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