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Fundoplication

Understanding Gastroesophageal Reflux Disease (GERD) and Fundoplication

Fundoplication surgery is a well-established treatment for individuals suffering from severe gastroesophageal reflux disease (GERD). GERD is a condition where stomach acid frequently flows back into the esophagus, causing discomfort, damage to the esophageal lining, and a range of symptoms that can significantly impact quality of life. When lifestyle changes and medications do not provide sufficient relief, fundoplication surgery offers a long-term solution by strengthening the barrier between the stomach and the esophagus, reducing acid reflux and improving symptoms.

Fundoplication is a minimally invasive procedure designed to prevent acid reflux and alleviate symptoms in people with GERD. During this surgery, the upper part of the stomach called the fundus, is wrapped around the lower esophageal sphincter to strengthen it, creating a barrier that prevents stomach acid from moving back up. Fundoplication is performed using laparoscopic techniques, which allows for smaller incisions, less postoperative pain, and faster recovery compared to open surgery.

GERD and Fundoplication in Australia

GERD is a common condition in Australia, affecting approximately 10-15% of the population on a regular basis. Chronic acid reflux not only impacts patients’ quality of life but can also lead to more severe health complications, including esophagitis, Barrett’s esophagus, and an increased risk of esophageal cancer. The incidence of GERD continues to rise in Australia, largely due to factors such as diet, obesity, and lifestyle habits. Fundoplication has become an increasingly common surgical solution for those who do not find relief from other treatments, providing Australians with a long-lasting alternative to medication.

Symptoms of GERD

Patients with GERD typically experience a range of symptoms, including:

  • Persistent heartburn
  • Regurgitation of acid or food
  • Chest pain or discomfort, especially after eating
  • Difficulty swallowing
  • Chronic cough or hoarseness
  • Sore throat or sensation of a lump in the throat

Causes of GERD

GERD is often caused by a weakening of the lower esophageal sphincter (LES), which allows acid to flow back into the esophagus. Risk factors include:

  • Obesity
  • Diets high in fatty or spicy foods
  • Excessive caffeine or alcohol intake
  • Smoking
  • Hiatal hernia
  • Pregnancy
  • Certain medications

Diagnostic Tests for GERD

To confirm a GERD diagnosis and assess the need for fundoplication, doctors may order one or more of the following tests:

  • Endoscopy: A small camera is used to examine the esophagus and stomach lining for signs of inflammation or damage.
  • pH Monitoring: Measures acid levels in the esophagus over 24 hours to detect abnormal reflux.
  • Esophageal Manometry: Tests the function of the esophageal muscles, especially the lower esophageal sphincter.
  • Barium Swallow: X-ray imaging to visualise the esophagus and stomach during swallowing.

Complications of Untreated GERD

Without treatment, GERD can lead to complications, including:

  • Esophagitis: Inflammation and erosion of the esophagus lining
  • Barrett’s Esophagus: Pre-cancerous changes to the esophageal lining
  • Esophageal Stricture: Narrowing of the esophagus due to scar tissue
  • Respiratory Issues: Chronic cough, asthma, or lung infections caused by acid aspiration

Treatment Options

Treatment for GERD typically begins with lifestyle modifications and medications, including antacids, H2 blockers, or proton pump inhibitors (PPIs). However, when these options fail to alleviate symptoms or when complications arise, fundoplication surgery is recommended. There are various fundoplication techniques, including the Nissen fundoplication, which involves a complete 360-degree wrap of the stomach around the esophagus and partial wraps (Toupet or Dor) tailored to individual needs. These procedures help prevent reflux and provide long-term relief from GERD symptoms.

 

For more information or to book a consultation with Dr Craven, please call us on (03) 9852 3777 or email us at info@dralexcraven.com.au.

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Frequently Asked Questions About Fundoplication

Postoperative discomfort is generally minimal, as the surgery is performed laparoscopically, and most patients return home within a day or two. Pain can usually be managed with over-the-counter medication.

Many patients can discontinue their GERD medications after fundoplication, although some may need a reduced dosage for a short time post-surgery.

Recovery times vary, but most people can return to normal activities within 2-4 weeks, with dietary adjustments in the initial recovery phase.

Fundoplication can sometimes be reversed if necessary, but this is uncommon and generally only considered if complications arise or symptoms persist.

For individuals in Australia struggling with persistent GERD symptoms, fundoplication surgery can be a reliable and effective solution for achieving a life free from acid reflux.

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