GERD (gastroesophageal reflux disease)
Q: What is reflux?
A: REflux is a condition that is responsible for the symptom described as heartburn. IT is called heartburn because there is a feeling of burn and pain at times in the upper abdomen. IT is the result of the failure of the valve between the esophagus and the stomach, to stop acid from going up.
Q: Why does this happen?
A: As we age the sphincter that separates the stomach and the esophagus fails and allows for acid and sometimes food to go up into the esophagus. The esophagus is not designed to withstand acid. As the acid touches the esophagus, it damages it and causes inflammation called esophagitis. This could lead to more serious problems and that is why it should be treated. At times there is a Hiatal hernia and this can make the condition worse or be the main cause of the reflux.
Q: What are the treatment options?
A: Even though Dr. Rafael Lugo is a surgeon, he treats reflux in all its stages. GERD is mainly a medical condition and it is treated with lifestyle modifications and at times with the help of antiacids. Anti-acid medications can be sued, but it is important to diagnose the severity of the reflux and also to try to identify the exact cause. antiacid medications are not meant to be taken for prolonged periods of time and can also lead to the development of other problems. surgery is usually reserved for the more severe cases of reflux and people with large Hiatal hernias.
Medications only treat the symptoms of reflux and not the cause. Reflux is a mechanical problem and not a chemical problem. REducing the acid decreases symptoms but does not solve the main problem.
Q: What is a hiatal hernia?
A: A hiatal hernia is a defect in the diaphragm at the entry side of the esophagus as it comes down from the chest to the abdomen.
Q: How do i get a hiatal hernia?
A: Usually is from birth and as it gets larger then causes symptoms.
Q: Do I have to always fix a hiatal hernia?
A: A hiatal hernia is repaired depending on its size and if it is symptomatic.
Q: What is the operation to control the reflux?
A: Nowadays there are many procedures and each patient is very special and needs a complete assessment to determine the best modality and procedure. IT is a very personalized process and decision-making depending on the needs the patient has. The gold standard for all procedures always has been the Nissen Fundoplication. This operation includes the repair of the Hiatal hernia and then the recreation of the valve between the esophagus and the stomach by wrapping the stomach around the distal esophagus and that way preventing acid and food from coming up.
Q: How effective is the operation for reflux?
A: The operation is highly effective and in many instances allows the patients to stop taking medications and have a normal life eating all they want that before caused heartburn. The key is to have a complete workup and a very personalized plan to treat the condition causing the reflux. Other procedures can be done instead of surgery and they are considered when recommending the best option. Dr. Lugo assures that the patient understands the pros and cons of each modality and helps decide the best course of action to follow.
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