Heartburn Surgery
Dr. Harris was trained extensively in the surgical treatment of heartburn at the Mayo Clinic by some of the nation's leaders in minimally invasive surgery. Many patients with significant heartburn have a hiatal hernia but you do not have to have a hiatal hernia to be an excellent candidate for heartburn surgery. If your heartburn is reasonably controlled by medications and you do not have a significant hiatal hernia, then surgery is often not necessary unless you prefer to get off heartburn medications. The tests that are generally undertaken before anti-reflux surgery are an upper endoscopy, a barium esophagram, esophageal manometry, esophageal pH testing and sometimes gastric emptying.
Traditional anti-reflux surgery consists of a fundoplication which is performed by wrapping the fundus of the stomach (this is the floppy part of the upper stomach) around the end of the esophagus in either a partial or full wrap. A full wrap is called a Nissen fundoplication. There is also a device called LINX that can be used instead of a fundoplication though it is often not covered by insurance. Anti-reflux surgery usually requires a one night stay in the hospital and is almost always done laparoscopically.
Proton pump inhibitor medications are the first line treatment heartburn. These work by powerfully reducing the amount of acid the stomach produces. However, they do not to stop stomach contents from refluxing into the esophagus where they can still cause symptoms even though stomach contents may not longer be acidic. Some studies have suggested that long-term use of proton pump inhibitors may have negative health consequences. The LINX device has been in use for over 10 years and has less side effects than the Nissen fundoplication. The device consists of a ring of magnetic beads that augment the lower esophageal sphincter. Despite positive study results, most insurance companies have refused to pay for the LINX device. Patients often have to pay for the device if they would like it used. Although LINX has not been studied long enough to know for certain, it is believed that the device will continue to effectively prevent reflux for life which may be an advantage over a traditional fundoplication which may loosen over 10 years or more and require repeat surgery is needed in a small percentage of patients.
What causes heartburn?
The sphincter between the esophagus and stomach is weak and allows stomach acid to get into the esophagus. Nicotine, caffeine, and alcohol can relax the sphincter and make reflux worse. Lying down after eating frequently makes heartburn worse. Being overweight also makes heartburn worse.
How successful is heartburn surgery?
Most studies have shown that over 90% of patients are happy with their heartburn surgery. Most patients can come off all their heartburn medications.
What are the side effects of heartburn surgery?
It is typically more difficult to belch after a fundoplication and this can lead to some bloating for some patients which is generally relatively minor and lessens over time. It is also more difficult to vomit after a fundoplication.
Can heartburn cause cancer?
Yes but this is extremely rare compared to the large number of people who have heartburn.
*Dr. Harris has no financial interest in the LINX device or the company that manufactures it.
Contact Dr. Harris Today
Dr. Adam S. Harris, M.D. is a board-certified General Surgeon in Birmingham, AL. If you want to learn more about how Dr. Adam Harris, can help you with heartburn surgery in Birmingham, schedule an appointment today at (205) 995-9700.