Gastroesophageal Reflux Disease
  Laparoscopic Antireflux Surgery
   
  “Heartburn is a common problem in the Western world. Approximately 7% of the population experience symptoms of heartburn daily. An abnormal esophageal exposure to gastric juice is probably present in 20-40% of this population, meaning this people have GERD.”
   
   
 
Surgical Procedures  >   Laparoscopic Antireflux Surgery  >   Diagnosis & Treatment    
 

Diagnosis

The main factor related to GERD is a defective LES (Lower Esophageal Sphincter), nevertheless, many other factors exist that can lead to GERD without relation to the adequate function of this “valve”, and therefore, tests to assess the function of the LES, esophageal body, and stomach may be appropriate in the majority of patients with GERD symptoms.

Since physical examination of patients with GERD symptoms rarely contributes to confirmation of diagnosis, some tests are required.

Preoperative Physiologic and/or Imaging Tests

  • EGD (esophagogastroduodenoscopy or upper endoscopy)**
  • pH Monitoring (considered the “gold standard” for the diagnosis of GERD)**
  • Esophageal manometry **
  • Contrast radiographs (barium swallow, upper gastrointestinal series)
  • Acid infusion test
  • Scintigraphy

**These tests are mandatory in almost all patients, the rest, are reserved for atypical symptoms or atypical response to medication.

Treatment
As mentioned earlier, the best, long lasting and most effective treatment for gerd is surgery, which involves in the making of a “new valve” or sphinchter at the end part of the esophagus using the upper part of the stomach (a stomach wrap, nissen fundoplication).

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