Acid reflux is a problem most people experience at some point in their lives, but when it becomes chronic, it's necessary to see a specialist like Dr. Erica Podolsky at South Palm Beach Surgical Associates in Boca Raton, Florida. Chronic acid reflux, or GERD, is a potentially serious digestive issue – one that can lead to complications such as esophageal stricture or ulcers. In its severe form, acid reflux might even require surgical intervention.
Put simply, acid reflux, or gastroesophageal reflux disease, occurs when the stomach contents move back up into the esophagus – the tube that allows food to go from the mouth to the stomach for digestion. The stomach is a hollow organ that contains digestive acids that break down food before it travels to the intestines.
When you swallow, the lower end of your esophagus relaxes to allow the food to pass. Once the food enters the stomach, it closes back up to prevent the acid from leaving the organ. Unfortunately, that doesn't always go as planned. When the valve responsible for closing off the stomach gets weak or sticks, acid flows back up causing heartburn, irritation, and even chest pain.
GERD is an acronym for gastroesophageal reflux disease, but it is usually associated with chronic acid reflux, as opposed to the occasional case. The continual irritation of the esophageal lining can lead to serious medical problems like the inability to swallow food, for example. Often, re-occurring acid reflux is associated with another condition – a hiatal hernia.
A hiatal hernia occurs as the stomach pushes upward through the diaphragm. There is a small opening in the diaphragm to allow the esophagus to pass through and connect to the stomach. When the stomach pushes upward through that opening, it can cause acid to back up into the esophagus, creating acid reflux.
Treatment for acid reflux depends on a number of factors. Mild and occasional reflux reduces with lifestyle changes and over-the-counter meds like an antacid. Dr. Podolsky will evaluate each patient and, generally, try these conventional approaches first to reduce incidents of discomfort. There are surgical options for serious reflux disease, including the Nissen fundoplication.
The Nissen fundoplication is a surgical procedure used for both GERD and a hiatal hernia. It is a laparoscopic technique that allows Dr. Podolsky to tighten the valve in the esophagus, called the esophageal sphincter, to prevent reflux. The doctor wraps the top of the stomach around that area to support the sphincter. This way, when the stomach contracts as part of the digestive process, it closes the esophagus at the same time, preventing that backup of acid.