Reflux Surgery
Gastroesophageal Reflux (GER), or simply reflux disease, is defined as the leakage of acidic-peptic gastric fluid or, occasionally, alkaline secretions from the stomach contents into the esophagus…
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- Gastroesophageal Reflux (GER), or simply reflux disease, is defined as symptoms or pathological changes in the esophagus resulting from the leakage of acidic-peptic gastric fluid or, occasionally, alkaline secretions from the stomach contents into the esophagus. When refluxed stomach contents that return to the esophagus cause lesions detected endoscopically in the esophagus, this is called Reflux Esophagitis. Conversely, if a patient has reflux symptoms but no endoscopic damage, this is called Non-erosive Reflux disease.
What are the symptoms?
GER is one of the most common diseases. Retrosternal burning (burning behind the breastbone, heartburn, sour taste, bitter fluid coming into the mouth), the most important symptom of this disease, occurs once a month in 45% of individuals in Western societies, and at least once a day in 7%. Atypical symptoms of reflux include non-cardiac chest pain, asthma, pneumonia, hoarseness, dental lesions and bad breath. The main complications it can cause can be listed as follows;- Bleeding
- Ulcer
- Stricture
- Barrett Esophagus
- Distal esophageal carcinoma
- Pulmonary fibrosis
- Asthma
- Chronic bronchitis
- Pneumonia
- Laryngitis
- Vocal cord ulcers
- Laryngeal stenosis
- Pharyngitis
- Torticollis
- Loss of tooth/gingival structures
- Mouth ulcers
- Otitis
- Chronic sinusitis
How is reflux diagnosed?
Diagnosis is made based on the patient's history and endoscopy (Gastroscopy). If the patient's complaints are severe but no significant finding is seen on endoscopy, 24-hour pH-meter monitoring is performed.
Reflux treatment
There are medical and surgical treatment options for reflux disease. To apply these treatment options, the pathophysiological cause of reflux in that patient must be carefully examined. In particular, the presence of lower esophageal sphincter insufficiency and a large hiatal hernia (Stomach Hernia) must be thoroughly established. In cases resistant to medical treatment, the presence of duodenogastric reflux should be investigated. These two treatment methods are not alternatives to each other; they are complementary treatment methods.
Reflux surgery
Surgical treatment of GER disease can be performed via an abdominal or thoracic approach. Today, the most preferred method in surgery is the Laparoscopic Nissen Fundoplication procedure. Laparoscopic surgery is a technique performed by entering the abdomen through small openings with trocars. It is usually performed using 4 or 5 ports (entry holes). If there is a stomach hernia, the hernia is repaired first. Afterwards, a suitable anti-reflux surgical mechanism is created for the patient. In this stage, called the fundoplication procedure, a valve mechanism of most often 360 degrees, and rarely 270 degrees, is created. Thus, food is pushed into the stomach by the forward contraction movement of the esophagus, but backflow is prevented. The patient, discharged the next day, consumes liquids and soft foods for 1 week. Afterwards, the diet is gradually expanded, and at the end of the 2nd week there is no need for any restriction other than chewing well and eating slowly. Success in laparoscopic Nissen surgery depends on 2 conditions. The first is selecting the appropriate patient through preoperative evaluations, and the second is the experience of the surgeon and team in this area. In almost all large published series, the success rate of Nissen surgery is above 90%.
Diagnosis is made based on the patient's history and endoscopy (Gastroscopy). If the patient's complaints are severe but no significant finding is seen on endoscopy, 24-hour pH-meter monitoring is performed.
Author
Web and Medical Editorial BoardReviewed by a specialist
Assoc. Prof. Dr. S. Hilmi AksoyInterventional RadiologyReview date: 02 November 2026Contact
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The Hisar Hospital Web and Medical Editorial Board contributed to the development of this content. All content on this website is provided for general informational purposes only. Please consult a physician for the evaluation, diagnosis and treatment of your condition.
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