Chirurgia del Reflusso Gastroesofageo e dell’Ernia Iatale

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Chirurgia del Reflusso Gastroesofageo e dell’Ernia Iatale

Gastroesophageal reflux disease (GERD), also known as acid reflux, is a long term condition where stomach contents come back up into the esophagus resulting in either symptoms or complications
 

 

Gastroesophageal reflux disease: pathology

Failure of the lower esophageal sphincter
Hiatal hernia: migration of part of the stomach into the chest, through a weak point of the diaphragm (muscle that separates the chest from the abdomen)
 

Gastroesophageal reflux disease: signs and symptoms

Typical symptoms are:

  • Regurgitation
  • Heartburn

 

Besides the typical symptoms, reflux can cause:

  • Pharingitis
  • Caugh, sore throat
  • Pain with swallowing
  • Inflammation of the oral cavity
  • Chest pain
  • tachycardia
  • increased salivation

 

 

Gastroesophageal reflux disease and hiatal hernia: diagnosis

  • Esophagogastroduodenoscopy (EGDS)
  • Double contrast swallow X-ray
  • Manometry
  • Esophageal pH 24h monitoring

 

Gastroesophageal reflux disease: lifestyle tips

  • stop smoking
  • Avoid fatty foods and big meals, especially in the evening
  • Avoid,acidic food (tomato, lemon), mint, chocolates alcohol, and caffeinated beverages
  • Avoid lying down for at least three hours after you eat,
  • Raise the head of your bed of about 10-15 cm so that your head and chest are higher than your feet
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    Gastroesophageal reflux disease: pharmacologic treatment

  • Antacids drugs: chemically neutralize stomach acid
  • Proton pump inhibitors: block acid production from cells of gastric mucosa

 

Gastroesophageal reflux disease: surgical treatment

Surgery, performed laparoscopically by expert surgeons, is the only treatment that can determine the cure of this disease in 95% of cases.
The procedure is called Nissen Fundoplication.
Aim: reestablish the contenitive mechanism of the antireflux barrier, preventing acid reflux
Procedure: the gastric fundus (upper part) of the stomach is wrapped, or plicated, around the lower end of the esophagus and stitched in place, reinforcing the closing function of the lower esophageal sphincter

 

If a Hiatal hernia is identified, it is possible to perform a hiatal hernia repair:
the procedure consists in:
 

  • Reduction of the hiatal hernia: the migrated stomach is pulled into the abdomen
  • Reconstruction of the hiatus (also with reinforcement materials)

 

Hiatal hernia repair can be performed during other bariatric procedures, such as:

  • Gastric Banding
  • Sleeve Gastrectomy
  • Gastric Bypass

 

All the above procedures are being performed in our Center.