Reflux: Surgical Treatment of Reflux

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Guest: Dr. David B. Adams - General and Gastrointestinal Surgery

Host: Dr. Linda Austin – Psychiatrist

Announcer: Welcome to an MUSC Health Podcast.

Dr. Linda Austin: I am Dr. Linda Austin, talking with Dr. David Adams, Professor of Surgery at the Medical University of South Carolina Digestive Disease Center. Dr. Adams, let’s talk about the surgical treatment of reflux disease. First of all, what is reflux?

Dr. David B. Adams: Reflux disease occurs when gastric juices and contents exit the stomach and go the opposite way they are supposed to go and they go back up into the esophagus, the tube that goes from the mouth to the stomach, and they can cause injury and inflammation of the esophagus. Most commonly, it just causes heartburn and in the vast majority of people, heartburn can be managed by medical means, weight loss, change in your diet and medicines which lower the acid, but in some patients despite the best medical effort possible, the reflux of gastric juices and content into the esophagus continues and injury continues and this can lead to the development not just of terrible pain that can't be controlled with medicines, but it can also cause scarring in the esophagus, you can get strictures that block the esophagus off, and get bleeding in the esophagus. It can cause serious problems that require surgical treatment to correct.

Dr. Linda Austin: So, what is that surgical treatment?

Dr. David B. Adams: Surgical treatment is an operation that’s been done for over 50 years and it had excellent results when it was done with open operations. It’s equally effective when done with a laparoscopic procedure and so that’s been a great change in the way heartburn and gastroesophageal reflux disease is treated because patients can have an operation that successfully fixes a problem and they don’t have to be cracked in half like a coconut. You can do it with a laparoscope with five small puncture sites in the abdomen operating on the TV camera. Patients have the operation and usually go home the next day.

Dr. Linda Austin: How long does the procedure itself take?

Dr. Linda Austin: The procedure takes two to three hours. Difficulty depends on how big hernia they have associated with their reflux. It may depend on how long they have had reflux and how much scarring depends on the patient’s anatomy and how easy or difficult that is to work with.

Dr. Linda Austin: And here at the DDC, what are our success rates with that procedure?

Dr. David B. Adams: Our success rates are similar to those that are reported nationally. So that, if you have a gastroesophageal reflux disease that has not been successfully treated with medical treatment and the symptoms are related to the injury to the esophagus, then the success rate with surgery is about 90% to 95% and that means patients are off medicines and they are eating and swallowing normally. If the symptoms that you have are related not just to the esophagus, but they are causing injury to your vocal cords, causing you to have asthma, causing you to have wheezing, issues related to the reflux getting out of the esophagus and into the upper airway then the success rate turn as good, they are probably about 70% in that situation.

Dr. Linda Austin: It must be so gratifying not only to the patients, but to you to be able to help folks relatively quickly with what can be a very severe problem.

Dr. David B. Adams: In patients, who are really enjoy seeing, most are those young working people, who can’t follow all the medical therapy and they can’t stop in their job to take a medicine every four hours. They have to work lying down and they have to lift heavy objects. So, a young person who is just miserable with reflux and then you can with a simple operation fix something that’s broken is very gratifying and they do very, very well.

Dr. Linda Austin: Dr. Adams, thank you so much.

Dr. David B. Adams: You are welcome.

Announcer: If you have any questions about the services or programs offered at the Medical University of South Carolina or if you would like to schedule an appointment with one of our physicians, please call MUSC Health Connection at (843) 792-1414.

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