REFLUX

Reflux ( Stomach Hernia ) Surgery

What is Reflux?

Reflux literally means escape. There are many places in the body where reflux can happen, and each one is caused by a different disease. Gastroesophageal Reflux is the backflow of stomach contents into the esophagus. This happens when there is reflux at the point where the esophagus meets the stomach. Reflux can be caused by many different things. Even newborn babies have natural (physiological) reflux because their muscles are not working right. Reflux alone is not important. What comes up in reflux is what makes it important. The stomach’s contents are acidic, so when reflux happens, the lower end of the meal line is exposed to acid. Normal stomach tissue can handle acid, but esophageal tissue is very sensitive to acid and gets irritated by it. When the lower end of the esophagus is exposed to acid for a long time because of long-term reflux, it can cause severe irritations and raise the risk of Barret esophagus disease and cancer of the lower end of the esophagus.

How to Diagnose Reflux?

Endoscopy is the best way to figure out if someone has reflux. It is often called the valve between the esophagus and the stomach during an endoscopy. We can tell that the stomach is getting bigger because there is not enough room in the hiatus area and the stomach is moving from the abdominal cavity to the thoracic cavity. On a chest x-ray or thoracic tomography, it can sometimes be seen by chance. But an endoscopy is needed to make a final diagnosis. If a hernia is found during an endoscopy, 24-hour Ph monitoring helps us figure out what is wrong.

What are the Symptoms of Reflux?

• Bitter water in mouth
• Burning in the stomach
• Nausea feeling
• Bad odor in the mouth
• Burping sensation
• Dry cough
• Asthma attacks
• Shortness of breath
• Burning sensation in chest
• Hoarseness

What causes reflux?

If we want to explain reflux in simple terms, it happens when the mechanism that opens and closes the valve only in one direction breaks down and lets fluid flow in both directions. But this change does not always happen when things are out of order.

• Reflux can sometimes be caused by the food we eat. Foods like fried foods, high-fat meals, milk, and other dairy products can relax the sphincter and cause reflux even in people who are not sick.
• Also, caffeinated drinks like coffee, cola, and energy drinks that make stomach acid rise, as well as alcohol and spicy foods, can cause reflux even when you are not sick.
• Especially eating foods like those in the above-mentioned diet late at night and then going to bed right after can also cause reflux.
• Being overweight increases reflux
• Some painkillers and medicines for high blood pressure can make reflux worse.
• Hernia (hiatal hernia) can cause reflux because of genetics, frequent weight gain, eating big bites without chewing enough, or being used to eating a lot of food at once. If reflux happens because of this cause, surgery is the only way to treat it. All other causes can be fixed by changing what you eat and how you live.

Who gets reflux?

Even though the amount of reflux varies depending on how people eat and their genetic background, it happens to about 40% of people on average.

• Two out of ten people look for a way to treat reflux.
• Even though it can happen to people of any age, it happens most often to people between the ages of 35 and 45.
• It can be seen in the way their bodies work when they are born. It goes away on its own by the time the child is at least 4 years old.
• It happens more often in fat people.
• People who gain and lose weight a lot are more likely to have it.
• Stress does not cause reflux, but people who are stressed feel the symptoms of reflux more.
• It happens more often in people whose genes make them more likely to get it.

What can untreated reflux lead to?

The stomach’s normal mucosa can handle acid, but the esophagus’s mucosa is very sensitive to acid. Because of this, if the acidic liquid in the stomach stays in the esophagus for a long time because of reflux, it can cause serious irritation and lead to some bad things in the long run.

When the esophagus is irritated for a long time, it can be hard to swallow, especially solid foods, because the movement that sends food down the esophagus will not work as well.

Also, if the irritation lasts for a long time, the end of the esophagus can become inflamed and tight, making it impossible for the person to swallow solid foods.

Because long-term acid exposure changes the structure of the esophagus, 5% of people with advanced GERD may get cancer at the bottom of their esophagus.

How is Reflux Treatment done?

To treat reflux correctly, the cause must be found. If not, it is a disease that is easy to treat in the wrong way. We can put it all together under two main categories.

Non-surgical treatments:

Lifestyle changes

One of the most common things that cause reflux is eating the wrong things. So, people with reflux should avoid foods like fried foods, fatty foods, spicy foods, milk and dairy products, coffee and other caffeinated drinks, alcohol, and cigarettes. They should also change the way they eat, especially late at night, and not go to bed right after eating. If there is no underlying problem, like a gastric hernia, reflux is usually treated by doing things like exercising regularly and losing weight.

Medication

In particular, people with too much stomach acid can be treated with drugs that protect the stomach and neutralize stomach acid, in addition to making changes to their lifestyle.

Surgical treatments:

Endoscopic Methods:

Even though there are ways to treat the problem without surgery, like suturing with an endoscope, squeezing foam on the valve area, or using radiofrequency, these methods have low success rates and have not yet been fully accepted as a treatment option. There are still experiments being done to make it better.

Laparoscopic Methods:

It is the best way to treat acid reflux caused by a hernia in the stomach. There are two main ways to do it.

• Classical Laparoscopic Method: This method is usually done by making 5 small holes in the abdomen of the patient.
• Scarless Laparoscopic Method: In this method, a single cut is made through the belly button of the patient without leaving any scars. The difference between this method and traditional laparoscopy is that it is done through a single hole and does not leave any scars on the patient’s abdomen.