a very common complaint that causes many of us pain and continuing discomfort which certainly interferes with our quality of life.<\/p>\n
What can one do about it? Is an operation the option?<\/p>\n
The problem is caused by stomach contents flowing back into the esophagus creating a burning pain in the lower chest.
\nThe backflow of gastric juice, bile, and\u00a0other stomach content into the esophagus\u00a0is frequent and can start occasionally already in\u00a0early\u00a0childhood. Sixty percent of the adult population will experience some type of Gastro-Esophageal Reflux Disease (GERD) within a 12 month period and 20 to 30 percent will have weekly symptoms.<\/p>\n
Sometimes it can indicate the presence of a hiatal hernia.\u00a0This is a condition in which the diaphragm does not close tightly enough around the gullet and a portion of the stomach protrudes upward into the chest.<\/p>\n
The occasional acidity attack is harmless. Problems arise when the closure mechanism between the esophagus and the stomach does not work properly\u00a0and the acid stomach content as well as bile can constantly attack the inner lining of the esophagus, it\u2019s mucosa.<\/p>\n
In this case, the burning pain behind the breast bone become chronic.<\/p>\n
This\u00a0not only decreases the quality of life to\u00a0a large extent but can become outright dangerous: the chronically irritated esophageal mucosa can change into more acid resistant tissue called “Barrett mucosa” or “Barrett Esophagus.” \u00a0This happens in 10 \u2013 15% of patients where the changed mucosa reduces the burning sensation and by doing so unfortunately makes the situation more dangerous\u00a0as some of these patients will eventually develop cancer of the esophagus.<\/p>\n
Most patients who suffer from chronic heartburn will “treat” themselves\u00a0often\u00a0with some self prescribed therapy. This unfortunately only suppresses the symptoms but can not change the basis of the problem i.e. that the closure mechanism does not work. Therefore gastric juice \u2013 although due to the medication less acid \u2013 as well as bile and food particles\u00a0–\u00a0still flow back into the gullet. Consequently the mucosal changes continue and the danger of developing a malignancy at some later stage remains.<\/p>\n
![\"\"](\"http:\/\/www.chirurgie-mallorca.com\/wp-content\/uploads\/2017\/06\/hiatusHernia-1024x421.jpg\")
\nBut there is another aspect to the problem:\u00a0\u00a0because the medication gives some kind of relief to the problem, patients take the medication which buffers the acidity or reduces the acid production in the stomach for a long time, often over years, sometimes even decades.\u00a0\u00a0This can have serious side effects, it can cause the mucosa to recede and infections become more frequent because the acidity, which kills the bacteria, is lacking.<\/p>\n
Consequently all patients with chronic heartburn should have a\u00a0check\u00a0with a fiber-optic instrument\u00a0\u00a0(esophago-gastro-duodenoscopy)\u00a0for the cause of the symptoms and\u00a0possible pathological changes.\u00a0If the reason for\u00a0the symptoms lies in insufficient closure at the entrance of the stomach perhaps in connection with a hiatal hernia, the therapy of choice could be the “laparoscopic fundoplication.”\u00a0\u00a0In this operation a “cuff” is formed from the upper stomach and then put around the lower part of the gullet which will close the stomach properly and disallow any back flow. At the same time the hiatal hernia will be closed.<\/p>\n
As the operation is done via the laparoscopic i.e. “key-hole” technique, there will be no large cut in the abdomen\u00a0as in the past\u00a0followed by\u00a0a hospital stay of 7 \u2013 10 days. Today\u00a0only a few\u00a0very small\u00a0incisions\u00a0are made\u00a0and\u00a0in most cases discharge from hospital\u00a0is done\u00a0on the 3rd postoperative day.
\nYes, heartburn can be operated on. And surgery is a good and relatively easy option and solution for a permanent cure.<\/p>\n","protected":false},"excerpt":{"rendered":"