Fundoplication (GERD) Surgery: Laparoscopic Antireflux Procedure

Written by Matthew Hoffman, MD

• Surgery
• Endoscopic Procedures
• What to Expect Afterward

The most common reason for surgery is heartburn that doesn’t go away with medications and lifestyle changes. Surgery may also be an option when you have:

• Severe inflammation of your esophagus, the tube that runs from your mouth to your stomach
• A narrowing of your esophagus that’s not caused by cancer
• Barrett’s esophagus, a change in the cells because of acid reflux

Before surgery, you’ll probably get tests to check how well the muscles in your esophagus work, including esophageal manometry and esophageal motility studies.

Because you’re taking a risk with any operation, you should consider surgery for acid reflux or GERD (gastroesophageal reflux disease) only after other treatments don’t work, and when there’s a good chance the operation will turn out well.

The main surgery for stubborn heartburn is called fundoplication. The surgeon can either directly touch the parts of your body they’re working on (open fundoplication), or they can use special tools, including a thin tube with a light and camera called a laparoscope, to operate on you from the outside.

Your surgeon will cut into your abdomen: one large cut for open surgery, or a few small ones for laparoscopic surgery. Then they’ll wrap all or part of the top part of your stomach around the lower part of your esophagus and sew it in place. This tightens the esophagus, which helps prevent stomach acid from backing up into it.

With the LINX procedure, your doctor uses a laparoscope to put a ring of titanium beads around the outside of your lower esophagus. This strengthens the valve between the esophagus and stomach. Food and liquids can still pass through.

These are usually the first things your doctor will do. They’ll put a flexible tube, called an endoscope, through your mouth and into your esophagus and stomach. The tube has a light and camera so they can see the inside of your body. Through the endoscope and using special tools, they can also take tissue samples and do surgery.

With a set of small tools at the tip of an endoscope, they can tightly bind the end of the esophagus to the top of the stomach. Or they could place stitches in the lower esophagus to form pleats that strengthen the area.

In the Stretta procedure, or radiofrequency treatment, the doctor directs high-energy waves into the wall of the lower esophagus to create small amounts of scar tissue. This will usually lessen heartburn and other acid reflux symptoms. You may need more than one treatment for a good result.

These procedures are often effective, although they may not work as well as surgery. But they don’t require cutting into your belly, putting you under general anesthesia, or a hospital stay.

You’ll have a shorter recovery time and less pain with laparoscopy. Plus it doesn’t leave a large scar. It’s considered “minimally invasive.”

Most people are satisfied with their surgery and its results. But surgery won’t get rid of all your symptoms, and the surgery has a failure rate of 10% to 15%. You may need to keep taking medication. About 1 in 10 people will need to have surgery again.

These operations are generally pretty safe and usually don’t cause other problems. You might:

• Have a hard time swallowing after the surgery
• Feel bloated often, called gas bloat syndrome
• Get an infection where you were cut

You should talk to your doctor about the pros and cons in your situation to decide whether surgery is a good choice for you.

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Choosing Over-the-Counter Heartburn Medication | TUMS

After eating your favorite lunch, dinner, or snack, you may have experienced a strange and uncomfortable burning in your chest. This burning feeling is known as heartburn, which is caused by stomach acid traveling up towards the throat—also known as acid reflux.¹ After you consume food, your stomach produces hydrochloric acid to help digest the food. Though your stomach has a mucous lining that helps to protect it from this acid, your esophagus does not. That’s why sometimes, when the acid reaches the esophagus, it causes a burning feeling.²

If you’ve experienced this burning feeling before, then you know just how uncomfortable it can be. Luckily, there is over-the-counter medication that can help alleviate the symptoms you may be experiencing with heartburn.

Identifying Common Symptoms and Causes of Heartburn

It is important to be able to identify the common symptoms of heartburn to understand what type of action you need to take for treatment. The most common symptoms of heartburn, besides the burning sensation in the center of your chest, can be symptoms like pain in your chest when you lay down or a burning sensation in your throat. ³ Other symptoms of heartburn may include difficulty swallowing and a hot, sour, or acidic taste in the back of your throat.⁴

You may find yourself experiencing these symptoms after consuming certain foods and drinks that can trigger heartburn. For example, citrus fruits, high-fat foods, tomato-based products, and alcohol have been known to cause heartburn.⁵ Other types of causes to consider can be more lifestyle-based, specifically for those who are active smokers, people who experience high levels of stress, and those who are overweight.⁶

Over-the-Counter Heartburn Medications

If you’ve been experiencing any of the symptoms of heartburn mentioned above, then it may be in your best interest to consider buying an OTC heartburn medication. Some of the most common over-the-counter medications include:

Antacids

These help to treat mild heartburn (acid indigestion) by reducing or neutralizing the amount of stomach acid you build up after eating certain foods. ⁷ Antacids help relieve heartburn to stop pain and other symptoms. They come in many different forms like chewable tablets, tablets that dissolve in water, and liquids you can drink.⁸ Antacids are ideal for people who don’t experience regular heartburn but may get indigestion from time to time. They should be taken at the onset of symptoms to help ease discomfort.

Antacids, like TUMS, are available in a range of great-tasting flavors and varieties. For example, you can buy TUMS Chewy Bites, which have the same extra-strength power of TUMS, but in a tasty, chewy bite. And like other OTC heartburn medication, you don’t need a doctor’s prescription, which is pretty convenient.

Proton pump inhibitors (PPIs)

These are used to treat frequent heartburn, working to reduce the amount of acid in your stomach.9 PPIs come in a number of different forms, including tablets, suspensions, and capsules. They are taken once a day for 14 days, regardless of the presence of symptoms. PPIs differ from antacids in that they treat frequent heartburn, or heartburn that occurs more than two days per week. They don’t function as quickly as antacids, but the relief they provide is longer-term.¹⁰

If you have frequent heartburn, you may benefit from a PPI such as Nexium 24HR, which provides 24-hour frequent heartburn protection. Take this quick heartburn quiz to find out if Nexium 24HR may be a solution for you.

Histamine Blockers (h3 Blockers)

These help to reduce the production of stomach acid, relieving acid indigestion, heartburn, and a sour stomach.¹¹ They come in a variety of forms like capsules, chewable tablets, and liquids. h3 blockers are taken before meals and the benefits last several hours¹² (not as long as PPIs). They are designed to provide relief for regular heartburn. Histamine blockers are generally effective at relieving most cases of chronic heartburn, however you should talk to your doctor about possibly switching to a PPI medication if you have frequent heartburn (or heartburn two or more days per week).

Antacids, histamine blockers, and proton pump inhibitors can all be over-the-counter medication for heartburn that could provide you with some relief. Make sure to always follow the instructions on the package of the OTC medication. If you’re unsure whether an antacid, PPI, or histamine blocker (h3 Blocker) is right for you, or how to use them, it’s always best to ask your doctor.

Consult with your doctor about other ways you can improve your diet and other lifestyle changes that can help prevent heartburn. Be sure to understand the causes and symptoms of heartburn, as symptoms could become worse and need immediate medical attention.

Learn more about TUMS products and discover more resources about the causes of heartburn, how to relieve heartburn, and more. Check out this article on what behaviors can trigger heartburn to understand how eating habits and even clothing choices could lead to heartburn.

References

By clicking any of the links below you will be taken to an external website that is independently operated and not managed by GSK. GSK assumes no responsibility for the content on the website. If you do not wish to leave this website, do not click on the links below.

1. Heartburn and acid reflux. https://www.nhs.uk/conditions/heartburn-and-acid-reflux/. Accessed on 11/05/2020.
2. Heartburn. https://medlineplus.gov/ency/anatomyvideos/000068.htm. Accessed on 11/05/2020.
3. Heartburn. https://my.clevelandclinic.org/health/diseases/9617-heartburn-overview. Accessed on 11/05/2020.
4. Heartburn. https://my.clevelandclinic.org/health/diseases/9617-heartburn-overview. Accessed on 11/05/2020.
5. Heartburn: Possible Causes. https://my.clevelandclinic.org/health/diseases/9617-heartburn-overview. Accessed on 11/05/2020.
6. Heartburn: Possible Causes. https://my.clevelandclinic.org/health/diseases/9617-heartburn-overview. Accessed on 11/05/2020.
7. Heartburn: Care and Treatment. https://my. clevelandclinic.org/health/diseases/9617-heartburn-overview/care-and-treatment. Accessed on 11/05/2020.
8. Antacids and Acid Reducers: OTC Relief for Heartburn and Acid Reflux. https://familydoctor.org/antacids-and-acid-reducers-otc-relief-for-heartburn-and-acid-reflux/. Accessed on 12/9/20/
9. Over-The-Counter (OTC) Heartburn Treatment. https://www.fda.gov/drugs/drug-information-consumers/over-counter-otc-heartburn-treatment. Accessed on 11/05/2020.\
10. Antacids and Acid Reducers: OTC Relief for Heartburn and Acid Reflux. https://familydoctor.org/antacids-and-acid-reducers-otc-relief-for-heartburn-and-acid-reflux/. Accessed on 12/9/20
11. Heartburn: Care and Treatment. https://my.clevelandclinic.org/health/diseases/9617-heartburn-overview/care-and-treatment. Accessed on 11/05/2020.
12. h3 blockers: MedlinePlus Medical Encyclopedia. https://medlineplus.gov/ency/patientinstructions/000382. htm. Accessed on 12/17/20.

adult symptoms and treatment, medicines, pills for vomiting and fever

How do we usually act when we feel bloated or have pain in the abdomen? We lie down, hug a pillow, take Spazmalgon or Nurofen and wait for everything to go away on its own – this is the main mistake! It’s one thing if you didn’t experience problems with the gastrointestinal tract before, but today you just ate expired cottage cheese. Another thing is dyspepsia. This serious disease requires the closest attention and comprehensive treatment so that life does not turn into a war with pain. We will tell you what to do with indigestion (dyspepsia) and what are the symptoms and treatment of this ailment.

Contents

1. What is indigestion?
2. Forms of indigestion
3. Causes of disease
4. Symptoms of indigestion
5. Diagnosis of indigestion
6. Treatment
7. Recommended medicines

Dyspepsia can have many different causes

What is indigestion?

Indigestion is a combination of digestive disorders caused by pathologies of the gastrointestinal tract (gastritis, ulcers, tumors, etc. ), disruptions in the psycho-emotional state, reactions to certain medications and other factors.

Forms of indigestion

1. Enzymatic. It appears due to the fact that the amount of digestive enzymes produced by the body becomes insufficient. This dyspepsia differs according to the source of enzyme deficiency: gastrogenic dyspepsia refers to the digestive organs, pancreatogenic dyspepsia to the pancreas, hepatogenic dyspepsia to the liver, and enterogenic dyspepsia to the intestines.
2. Simple (or alimentary). This type of indigestion in an adult and a child accompanies a disruption in the diet, when the balance of nutrients in the body is disturbed. If the predominance goes towards carbohydrates, then a fermentative type appears, if proteins predominate – a putrefactive type, and with excessive consumption of fats – a soapy (fatty) type of dyspepsia.
3. Infectious. The reason lies in various intestinal infections, such as dysentery.
4. Intoxication – i. e. due to poisoning of the body: its acute manifestation or concomitant with surgical injuries and the severe course of general infections.
5. Appeared as a result of a syndrome of chronic malabsorption of nutrients in the small intestine (malabsorption).

Causes of disease

Dyspepsia resulting from diseases of the gastrointestinal tract is called organic . Its causes can be the presence in the gastrointestinal tract of the bacterium Helicobacter pylori, gastritis, ulcers, diseases of the liver and pancreas, tumors of various origins and other pathologies of the gastrointestinal tract. Also, organic indigestion appears due to a lack of vitamins B and C, and in combination with a decrease in blood pressure – against the background of myocardial infarction.

A form of indigestion not associated with any organic pathology is called functional . For example, it includes various stresses, malnutrition, and the body’s response to medications received (especially antibiotics and hormonal drugs).

Symptoms of indigestion

There are standard and common symptoms of dyspepsia:

• pain, heaviness and feeling of fullness in the stomach;
• heartburn with acute burning;
• eructation of gastric juice;
• rumbling and bloating;
• constipation or diarrhea;
• nausea;
• Vomiting attacks (after vomiting in case of indigestion, temporary relief occurs).

The diagnosis is made in the presence of a set of basic criteria:

1. Every month, for a whole week, negative manifestations are felt in the upper abdomen and the pains that accompany them.
2. Data from clinical studies of the gastrointestinal tract (its upper sections) confirm that there are no organic changes in it.
3. Defecation does not relieve the presenting symptoms of indigestion, stool quality and frequency do not change.

Diagnosis of indigestion

As soon as you feel that something is wrong with your stomach, immediately make an appointment with a gastroenterologist.

After an external examination and description of complaints, he prescribes a complete examination, excluding other diseases of the gastrointestinal tract that are not related to dyspepsia. The complex of laboratory studies includes a general blood test and biochemistry, as well as a study of feces for occult blood and a coprogram. Additionally, a test is carried out for the level of stomach acidity and the presence of the Helicobacter pylori bacteria in it, FGDS (if necessary, along with a biopsy) and consultation with an endoscopist, abdominal ultrasound, X-ray, CT, colonoscopy, esophageal and antroduodenal manometry.

Investigations must confirm the absence of the following symptoms: trouble swallowing (dysphagia), blood in the stool, weight loss, and fever. Any signs of an inflammatory process in the body also exclude the diagnosis of indigestion.

Sometimes during treatment, the symptoms disappear too slowly or, on the contrary, progress. Then, to eliminate the error, two different diagnostics of the presence of H. pilori in the body are prescribed from the following:

• ELISA method for detecting bacteria in feces and examining feces for the presence of antibodies to H. pylori;
• PCR test bacteria;
• breath test for its presence.

After receiving comprehensive test results, the gastroenterologist confirms or refutes the diagnosis and prescribes the appropriate treatment.

Treatment

The main goal of the treatment of indigestion is to reduce the frequency of symptoms until they disappear completely, to minimize the risk of recurrence of dyspepsia and complications after the disease. Placing a patient in a hospital is required only if there are difficulties in diagnosis and research, in other cases the patient is treated at home.

Treatments for dyspepsia

1. Lifestyle change. For sleep, preference should be given to large and high pillows, after eating, go for a walk for at least an hour, give up abdominal exercises (but not gymnastics and physical education in general) and tight belts. It is recommended to exclude bad habits (tobacco and alcohol), as well as any situations that cause stress and overload of the body, both emotional and physical.
2. Nutritional intervention or diet therapy is the main treatment for dyspepsia. To restore the proper functioning of the gastrointestinal tract, it is necessary to exclude all spicy, salty, smoked, fried and spicy components that stimulate heartburn, strong drinks and soda. Food should not be too hot, cold or hard. Crushed food is used: during the day there should be 5-6 receptions with an interval of no more than 3.5 hours, food must be chewed very carefully, and after it, give up the desire to lie down, and actively move. And no overeating!
3. Psychotherapy. In addition to eliminating all possible stressful situations, the patient needs to learn the correct reaction to life’s negativity – yoga or swimming will help here. The specialist in the smallest detail tells about what led to the disease and how it proceeds. Sometimes the patient is prescribed sedatives (valerian herb or motherwort) or antidepressants.
4. Taking medications. A certain form of digestive upset dictates the choice of tablets for indigestion. In drug therapy, antacids and prokinetics, proton pump inhibitors and h3 receptor blockers, antibiotics, as well as bismuth preparations, various enzymes and complexes of vitamins C and group B are used.

Important! If there are signs of dyspepsia, it is recommended not to use non-steroidal anti-inflammatory drugs, as they adversely affect the condition of the gastric mucosa.

Recommended medicines

We list suspensions, powders and tablets for indigestion, which are freely sold in pharmacies without a doctor’s prescription.

1. Bismuth tripotassium dicitrate – used for peptic ulcer. It promotes rapid healing of ulcers, and its antibacterial action reduces the risk of recurrence. In fact, there are many bismuth preparations that are equally effective in the treatment of dyspepsia and have a similar effect.
2. Unienzyme – contains enzymes that help to quickly cope with the main symptoms of dyspepsia, flatulence and abdominal discomfort.
3. Almagel, Almagel Neo, Almagel A – antacid, relieves pain and reduces acidity in the esophagus. It also has anti-inflammatory, choleretic and laxative effects.
4. Phosphalugel – antacid, copes with the main symptoms of dyspepsia, including flatulence, pain, nausea and others.
5. Maalox is an antacid drug aimed at relieving pain in dyspepsia, the consequences of excessive consumption of coffee, nicotine and drugs.
6. Gastracid – This antacid reduces the symptoms of heartburn and hyperacidity.
7. Gaviscon – antacid, the main action is the fight against heartburn and belching with the release of gastric acid. It also effectively fights other manifestations of indigestion.
8. Rennie – provides fast and lasting relief from the effects of excess gastric juice and protects the gastric mucosa.
9. Preparations based on sucralfate (Venter, Antepsin, Sukrat, etc. ) – an antiulcer agent that protects the intestinal and stomach mucosa. Fights reflux, heartburn and other symptoms of the disease.
10. Sea buckthorn oil – has a pronounced wound healing and enveloping effect. Suitable for patients with gastritis and peptic ulcer.
11. Also widely used are traditional medicines that envelop the walls of the stomach and have an astringent effect – St. John’s wort, chamomile, flaxseed and plantain leaf.

Phosphalugel, 20% Oral Gel, 16 g, 20 pcs.

Aspen Pharma, France

Price

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Rennie, 680mg + 80mg, Chewable Tablets, Orange Flavor, 48 Tablets

Bayer, France

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Gaviscon Double Action, 250mg + 106.5mg + 187.5mg, chewable tablets, mint flavor, 12 tabs

Reckitt Benckiser, UK

Price

from 180₽

There are contraindications. Specialist consultation is required.

Sources

• Loginov A.S., Vasiliev Yu.V. // Non-ulcer dyspepsia // Russian Journal of Gastroenterology // 1999;
• Maev IV // Non-ulcer dyspepsia syndrome // Exp. and wedge. gastroenterol. // 2000.

The information is presented for informational purposes only and does not constitute medical advice or treatment guidance on the part of uteka.ru.

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Indigestion turned out to be a sign of a fatal disease

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Indigestion turned out to be a sign of a fatal diseases

Indigestion turned out to be a sign of a fatal disease – RIA Novosti, 03.03.20210002 Indigestion can be a sign of a deadly disease, Express writes about this, citing data from British doctors. RIA Novosti, 03.03.2021

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MOSCOW, March 3 – RIA Novosti. Indigestion can be a sign of a deadly disease, Express writes about this, citing data from British doctors. We are talking about pancreatic cancer. As a rule, patients suffering from this type of cancer experience a burning sensation in the chest and a bitter unpleasant taste in the mouth. Also, the disease is indicated by general discomfort in the abdomen extending to the back. Painful sensations can be constant or periodic, in the supine state the patient’s well-being worsens. Unpleasant symptoms also increase after eating food. In addition, in the event of pancreatic cancer, a person can lose weight dramatically. Patients also suffer from nausea, complain of loss of appetite, diarrhea or constipation. Experts strongly recommend that if these symptoms appear, seek medical advice, undergo an examination and begin treatment. Pancreatic cancer is a malignant neoplasm emanating from the epithelium of the glandular tissue or pancreatic ducts. The symptoms of this disease are often not specific and not pronounced, and therefore the tumor in many cases is detected at the later stages of the process. Earlier, Russian doctor and TV presenter Alexander Myasnikov said that the formation of blood clots may indicate the presence of oncological diseases. According to him, if a blood clot occurs, the patient should undergo a complete examination so that doctors can determine the cause of its occurrence as accurately as possible, as well as exclude other dangerous conditions.

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7 495 645-6601 Moscow, Russia Today , March 3 – RIA Novosti . Indigestion can be a sign of a deadly disease, Express writes about this, citing data from British doctors.

This is pancreatic cancer. As a rule, patients suffering from this type of cancer experience a burning sensation in the chest and a bitter unpleasant taste in the mouth. Also, the disease is indicated by general discomfort in the abdomen extending to the back. Painful sensations can be constant or periodic, in the supine state the patient’s well-being worsens. Unpleasant symptoms are also aggravated after eating food.

In addition, in the event of pancreatic cancer, a person can lose weight dramatically. Patients also suffer from nausea, complain of loss of appetite, diarrhea or constipation.

Experts strongly recommend that you seek medical advice, be examined and begin treatment if you experience any of these symptoms.

An unexpected harbinger of cancer has been named

March 1, 2021, 01:41

Pancreatic cancer is a malignant neoplasm originating from the epithelium of the glandular tissue or pancreatic ducts. The symptoms of this disease are often not specific and not expressed, and therefore the tumor in many cases is detected in the later stages of the process.