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Gastroesophageal Reflux Disease (GERD)

An estimated 20% of people in the United States have GERD, according to the National Institute of Diabetes and Digestive and Kidney Diseases.1 This chronic condition is marked by persistent heartburn, not the occasional kind that can be treated with antacids. Chronic heartburn can interrupt sleep, limit activities, restrict certain foods, and generally change the way you live your life.

What Is GERD?

Gastroesophageal reflux disorder (GERD) is a common condition that occurs when stomach acid moves back up the esophagus toward the mouth, rather than remaining in the stomach as it should. This causes the lining of the esophagus to become irritated and inflamed, which may lead to more severe symptoms if left untreated. Similar to occasional acid reflux, GERD is typically experienced right after eating — sometimes producing a more intense reaction at night – however, patients that are diagnosed with GERD suffer more frequently, often at least one to two times every week. 

Over-the-counter or prescription medications may help to control GERD and ease symptoms, however those remedies may not be able to fix the cause. Individuals can be evaluated to determine if a surgical option, such as videoscopic surgery, may be recommended to fully address the condition.

At Suburban Surgical Care Specialists/Kane Center, our experienced Chicago-area general surgeons are committed to providing the least invasive procedures, whenever possible, with the latest technologies that will best serve the needs of our patients.

What Are the Symptoms of GERD?

Symptoms of GERD may vary for each individual, with some experiencing more symptoms than others. The most common signs someone has GERD include:

If the condition is not properly addressed, symptoms may become more severe and lead to serious health problems, such as an erosion, ulceration, or gastrointestinal (GI) bleeding.

Do You Have GERD?

Individuals can take the test below, which is based on an evaluation from the American College of Gastroenterology, to see if they might be suffering from GERD. 

Do you frequently have one or more of the following:

If you said “yes” to two or more of the above, you may have GERD. To know for sure, contact our practice for a complete evaluation.

When Should I See a Doctor for GERD?

Occasional heartburn after a big meal is normal and usually not cause for concern. However, you should schedule an appointment with a doctor if you experience heartburn more than twice a week, if over-the-counter antacids no longer provide relief, or if symptoms interfere with sleep, eating, or daily activities. Seek prompt medical attention if you notice difficulty or pain when swallowing, unexplained weight loss, persistent nausea or vomiting, or signs of bleeding such as black stools or vomit that looks like coffee grounds. Chest pain should always be evaluated right away, since it can sometimes signal a heart problem rather than reflux.

How Is GERD Diagnosed?

Diagnosis typically begins with a review of your symptoms and medical history, along with a trial of lifestyle changes or medication to see how you respond. If symptoms persist or your doctor wants to confirm the diagnosis, further testing may include an upper endoscopy to examine the esophagus and stomach lining, 24-hour esophageal pH monitoring to measure acid exposure, or esophageal manometry to assess how well the esophagus muscles are functioning. These tests help rule out other conditions, check for damage to the esophagus, and determine whether surgery may be a reasonable option.

What Happens if I Don’t Treat GERD?

Left untreated, GERD can lead to complications beyond ongoing discomfort. Repeated acid exposure can cause esophagitis, or inflammation of the esophageal lining, which may progress to ulcers or bleeding. Some patients develop esophageal strictures, a narrowing that makes swallowing difficult. Chronic, untreated reflux is also linked to Barrett’s esophagus, a change in the esophageal lining that carries a small increased risk of esophageal cancer. Beyond the esophagus itself, ongoing GERD can worsen asthma, damage tooth enamel, and disrupt sleep and quality of life. Early treatment helps prevent these complications from developing.

What Lifestyle Changes Can Improve GERD?

Whether you have occasional or severe chronic heartburn, the following basic lifestyle changes may help you manage your discomfort and benefit your overall health:

Additionally, certain medications can make heartburn worse because they either promote acid production, relax the lower esophageal sphincter (L.E.S.), or reduce saliva, such as:

Be sure to ask your pharmacist or doctor if any of your current medications could be contributing to your heartburn.

What Medications Can Help GERD?

If you have frequent or severe heartburn, your doctor may prescribe a medication. Most over-the-counter medications are available at your local pharmacy, while prescription medications must be approved and directed by your physician.

Remember, whether you’re on medication or not, lifestyle changes such as eating nutritious foods, getting exercise, and managing stress are an important part of feeling better. We highly recommend talking to your doctor about choosing the best treatment plan.

Am I a Candidate for GERD Surgery?

Not every person with GERD needs surgery, and it’s typically considered only after lifestyle changes and medication have failed to provide lasting relief. Good candidates often include those who don’t want a lifetime of medication, patients who experience side effects from their prescriptions, individuals whose symptoms persist despite maximum-dose treatment, and patients with confirmed reflux on diagnostic testing. Your doctor will review your health history, medication response, and test results to determine if you’re a suitable candidate, then refer you to a surgeon for a fuller evaluation if surgery looks like a good fit.

What Does Laparoscopic Surgery for GERD Involve?

Chronic heartburn or GERD is usually caused by the weakening of a valve above the stomach, allowing acids to reflux up into the esophagus. Laparoscopic surgery actually addresses the malfunctioning valve, “fixing” chronic heartburn in most cases. In this procedure, a surgeon wraps part of the stomach around the lower esophageal sphincter, which improves the performance of the sphincter preventing the reflux of acids from the stomach into the esophagus and eliminating heartburn.

A laparoscopic procedure is a less invasive alternative to traditional (open) surgery, as much smaller incisions are made to accommodate small tubes called “trocars.” The trocars create a passageway for special surgical instruments and a laparoscope — a fiberoptic instrument used to examine and transmit images from within the body to a video monitor, allowing the surgeon to see the operative area. Since the incisions are small (only about the size of a dime), scarring tends to be greatly reduced. Additionally, patients who are appropriate candidates for a laparoscopic procedure usually experience shorter hospital stays. Although surgery for chronic heartburn is often done laparoscopically, a surgeon may still recommend open surgery as the best procedure to improve the patient’s condition.

A comparison of laparoscopic GERD surgery vs open surgery:

Laparoscopic Surgery

Open Surgery

Studies show that over 90% of patients are symptom-free after a laparoscopic surgical procedure to correct gastroesophageal reflux disease. Of those patients studied, the quality-of-life assessment has been the most dramatically improved outcome variable.

Keep in mind that laparoscopic surgery is typically only an option for selected patients with severe chronic heartburn that still disrupts their lives, despite lifestyle modifications and appropriate medication, and shouldn’t be considered until all other measures have been tried. Other heartburn sufferers who may benefit from laparoscopic surgery include younger patients (50 years or younger) facing a lifetime of medications, patients who find medications a financial burden, patients who are noncompliant with their drug regimen, and patients who prefer a single intervention to long-term therapy. Diagnostic testing is critical for all patients to document the disease and determine whether surgery is an appropriate option.

Before surgery, a diagnostic evaluation must be made to ensure that gastroesophageal reflux is the underlying cause of the patient’s symptoms. This is usually done with 24-hour esophageal pH monitoring, endoscopy, and/or a manometry test.

If you have tried over-the-counter or prescription-strength medication without relief, see your doctor or gastroenterologist. Only your doctor can best determine whether you are a candidate for a laparoscopic surgical procedure to fix gastroesophageal reflux. If they confirm you may benefit from the procedure, you will then be referred to a surgeon. Your local medical center also can help you find a surgeon skilled in the laparoscopic procedure.

What Are the Side Effects of Laparoscopic GERD Surgery?

As with any surgery, there are risks associated with anesthesia, medication, bleeding, and infection. If complications occur during the operation, your doctor may choose to perform open surgery instead. Side effects more specific to laparoscopic GERD surgery may include:

Generally, side effects should subside within about four weeks following the procedure. When compared with pre-surgical symptoms, a 20-year follow-up study found that 86.7% of patients said they would make the same decision to undergo surgery for GERD again.2

It is important to note, the proper approach to surgery for gastroesophageal reflux (GERD) requires four careful considerations:

*Attention to these considerations will result in successful anti-reflux surgery in over 90% of all patients.

Questions to Ask Your Doctor

The best way to understand your medical options is to ask a professional. Below are questions that may serve as a helpful guide when speaking to your physician or surgeon.

Questions to ask your physician:

If videoscopic or laparoscopic surgery is right for you, your doctor may refer you to a surgeon who can better address your concerns. These additional questions may help.

Questions to ask your surgeon:

Learn More About GERD

For more information about GERD relief, or to find out if surgery is a recommended option for your condition, please contact us to schedule a consultation. 

Medical Resources for GERD

1 NIH: NIDDK Definition & Facts for GER & GERD
2 ScienceDirect, Antireflux Surgery’s Lifespan: 20 Years After Laparoscopic Fundoplication

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