Acid-Reflux Surgery? Your Top 10 Acid-Reflux Surgery Questions Answered
Anyone who has experienced acid reflux can tell you they relate with painful discomfort in the chest and burning sensation, especially after a meal. That feeling of discomfort is caused by one of the symptoms of acid reflux: Heartburn.
Heartburn is caused by irritation to the lining of the oesophagus from stomach acid being regurgitated. The regurgitation of acid into the oesophagus is known as acid reflux.
While there are no specific triggers to acid reflux, most people experience this condition after eating. It can worsen if you are lying in a reclined or resting position in bed, right after a meal.
“Acid reflux irritates the lining of your oesophagus. You may feel some discomfort, tightness or a burning sensation in your chest. If left untreated, it may lead to serious complications.” – Dr Ganesh Ramalingam
If you experience acid reflux more than twice a week, you are diagnosed with Gastroesophageal Reflux Disease, more commonly known as GERD. GERD can prove to be a very disruptive condition to your lifestyle and severely impair your ability to conduct daily activities.
While GERD is not immediately life-threatening, leaving it untreated can lead to severe health conditions such as oesophageal cancer. Fortunately, there’s a lot we can do about GERD and acid reflux through a procedure known commonly as acid reflux surgery or anti-reflux surgery.
Today, we answer some of the most common questions that you have about acid reflux surgery.
Question #1: What Is Acid Reflux Surgery?
Acid Reflux is usually treated with a procedure known as Nissen Fundoplication. It is a procedure targeted at treating acid reflux caused by Gastroesophageal Reflux Disease, commonly referred to as its abbreviation, GERD.
Gastroesophageal Reflux Disease (GERD) is a digestive disorder that occurs when stomach juices or food and fluids frequently flow back up from the stomach into the oesophagus.
This phenomenon is also known as acid regurgitation or gastroesophageal reflux. Frequent occurrence of gastroesophageal reflux can also cause the weakening of muscles along the lower oesophageal sphincter (LES), which controls the opening between the oesophagus and the stomach.
Nissen Fundoplication helps strengthen this opening to prevent food and acid from going back upwards. This procedure is also one of the most common surgeries used to treat GERD and has high success rates in helping patients overcome their symptoms for many years.
Question #2: How Successful Is Surgery for Acid Reflux?
Nissen fundoplication is a surgery option commonly used to treat GERD.
In a study conducted between 1992 to 2005, acid reflux surgery success rates were observed to be as high as 83%, where amongst patients who returned for long-term follow-up, there was low recurrence in their condition.
These patients also did not require medication after the surgery and have expressed that the outcome was better after acid reflux surgery than with medical treatment.
Question #3: How Long Does It Take to Recover From Acid Reflux Surgery?
Depending on the type of surgery that you undergo, the recovery time for acid reflux surgery may differ. Acid reflux surgeries can be conducted in one of two manners: open surgery or laparoscopic surgery.
Open surgery requires larger incisions to be made on your body and would naturally require a much longer recovery time. If you undergo open surgery, it is common to take 4 to 6 weeks to resume your normal routine.
On the other hand, laparoscopic surgeries require smaller incisions to your body and are less invasive. As such, if you undergo laparoscopic surgery, you are typically able to resume normal activities after three days and fully recover in two weeks if there are no complications.
Question #4: Can Acid Reflux Come Back After Surgery?
While some people who undergo acid reflux surgery may experience signs of bloating, it is very rare for patients to report no improvement in their symptoms at all.
With that said, reflux symptoms can recur even after surgery if you do not make changes to your lifestyle. This can include factors such as:
Drinking excessive alcohol
Smoking
Consuming acidic, oily or spicy food
Being overweight
It is also possible for acid reflux to recur if the surgery was not done successfully, causing the wrap around the oesophagus to be too tight or incorrectly placed, resulting in the need to repeat the surgery to fix the failure.
Question #5: Does Acid Reflux Surgery Lead to Weight Loss?
Acid reflux surgery can lead to weight loss.
Nissen fundoplication, the most common procedure used to treat acid reflux, requires a part of the stomach to be wrapped around the lower part of the oesophagus, preventing stomach acid from being regurgitated into the oesophagus.
This causes the stomach to have reduced space for food, making you feel fuller faster.
Apart from that, acid reflux surgery usually requires you to undergo a diet change where you consume softer and liquidised foods after the surgery. This can take as long as 2-3 months for your stomach to adjust before you can eat your usual amount of food, which can lead to weight loss.
Question #6: Does Insurance Cover Acid Reflux Surgery?
In Singapore, acid reflux surgeries are typically covered by insurance and medisave.
If you are unsure about your financing options and require advice, contact our team to understand more about the potential charges you need to be aware of before opting for an acid reflux surgery.
Question #7: What Foods Can I Eat After an Acid Reflux Surgery?
Most patients who undergo acid reflux surgery will need to make dietary changes to avoid complications after a procedure.
Following the surgery, you will be expected to make changes to your diet according to the different phases. Here is what may be recommended:
Recovery Phase (2 weeks after surgery): Liquid or soft diet. You are recommended to consume only liquid for the recovery phase and avoid carbonated beverages. Food such as soup and yoghurt are recommended.
Acclimatisation Phase (3-4 weeks after surgery): Soft to light solid food. You can start introducing solid food that is easily digestible into your diet. These can include bread and mashed potato. Your food should also not be overly spicy or oily to prevent causing discomfort.
Maintenance Phase (1 Month after surgery and long term): Solid food diet. You can return to your usual diet as before. However, you are advised to avoid eating food that is rough and may become stuck in your oesophagus, such as chicken, steak or nuts.
Question #8: Is Acid Reflux Surgery Similar to Hiatal Hernia Surgery?
Depending on the symptoms and condition, acid reflux surgery may be recommended together with a hiatal hernia repair of the diaphragm.
A hiatal hernia is a condition where the upper part of the stomach and oesophagus protrudes past the opening (also known as hiatus) in the diaphragm into the chest cavity. This results in the stomach bulging through the diaphragm, which may lead to worsening reflux and pain in the chest.
Patients who have a hiatal hernia may experience similar symptoms to that of GERD, depending on the location and size of the hiatus.
In such cases, Nissen fundoplication together with a diaphragm hernia repair are usually recommended by our doctor to prevent the symptoms from worsening.
Question #9: Can Gerd Be Cured Without Surgery?
GERD or acid reflux can be treated if you only experience mild symptoms from the condition.
Through lifestyle changes such as quitting smoking and alcohol, and losing weight through dietary changes, the chances of an acid reflux attack can be lowered, allowing the body to heal and repair the damage to the oesophagus and throat.
In some cases, the symptoms can also be alleviated using antacids and proton pump inhibitors (PPI) to reduce the effects of stomach acids on the oesophageal wall, helping to relieve the discomfort.
However, it is essential to know that acid reflux surgery (Nissen fundoplication) is the recommended option if lifestyle modification and medication for treatment of GERD fails. If you are unsure about which treatment to go for, seek professional advice from our doctor to understand more.
Question #10: What Are the Possible Side Effects of Acid Reflux Surgery?
An acid reflux surgery is a relatively safe procedure; however, as with most surgeries, some patients may experience rare side effects or complications.
The side effects may include:
Damage to the linings of the stomach, oesophagus or tissues around the lungs during the procedure
Infection from the wound
Pneumonia
Difficulty swallowing
Nausea
Excessive gas in the stomach / burping
In rare cases, the surgery may fail and result in the recurrence of reflux symptoms. In such cases, the wrap around the oesophagus could have been too tight or incorrectly placed, resulting in the need to repeat the surgery to fix the failure.
Conclusion
Acid reflux and GERD can prove to be very disruptive when left untreated. While changing your diet can be a way to prevent the condition, chronic acid reflux requires medical intervention to prevent it from developing into a serious health risk. Surgery like Nissen fundoplication is a good option if lifestyle modification and medication fails. This surgery may be done together with a hiatal hernia repair of the diaphragm.
If you are bothered by your condition, schedule an assessment with our doctor to better understand how you can manage and treat your condition.
Dr. Ganesh Ramalingam
Specialist in General Surgery
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