Reflux (Heartburn)
Diagnostics
To diagnose an inflammation of the oesophagus a gastroscopy is necessary, during which the alterations of the mucosa can be examined and samples can be taken.
The examination of the function of the oesophagus and the cardiac sphincter is performed with the so-called pH-balance metry, which measures the concentration of the gastric acid in the oesophagus. The pressure in the lower sphincter and the mobility of the oesophagus are examined during a so-called oesophageal manometry.
Surgical Method
The inflammation of the oesophagus caused by a reflux is initially treated with medication. Medicaments inhibit the production of gastric acid so that the backflowing gastric juice doesn't cause any more painful inflammation in the lower part of the oesophagus.
Surgery is suited for patients who don't want a lifelong medical treatment, who are not painfree under medication or whose stomach has slid partially into the thorax.
The operation is performed as minimal invasive surgery (MIT).
The surgical aim is to normalize the cardiac sphincter at the transition from the oesophagus to the stomach. This can be done by a shift of the transition from the oesophagus to the stomach into the abdominal cavity, by an occlusion of a diaphragmatic hernia and by an elevation of the obstructive pressure of the cardiac sphincter, which is achieved by folding a part of the stomach around the lower part of the oesophagus (like a cuff).
Surgical Risks
The operation is usually performed with a 270 degree cuff to avoid the build-up of too high pressure which can lead to dysphagia (difficulty in swallowing). Extensive research has shown that 90-95% of all patients don't need any post-operative medical treatment.
Special Questions
- Your stay in hospital will take a week. At the end of your treatment a contrast radiography will be done to show that no contrast medium flows back into the oesophagus.
- The operation can usually be performed as minimal invasive surgery.
- After surgery it is indispensable to chew your food properly and to eat slow, otherwise complaints can occur.
